Provider Demographics
NPI:1497099626
Name:SELBY, GIFTY
Entity Type:Individual
Prefix:
First Name:GIFTY
Middle Name:
Last Name:SELBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 RING RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5129
Mailing Address - Country:US
Mailing Address - Phone:336-907-5737
Mailing Address - Fax:336-375-0724
Practice Address - Street 1:2721 RING RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5129
Practice Address - Country:US
Practice Address - Phone:336-907-5737
Practice Address - Fax:336-375-0724
Is Sole Proprietor?:No
Enumeration Date:2012-11-10
Last Update Date:2012-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4554374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide