Provider Demographics
NPI:1710276134
Name:SELLO, CHASITY NICOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHASITY
Middle Name:NICOLE
Last Name:SELLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CHASITY
Other - Middle Name:NICOLE
Other - Last Name:SELLO-BRINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM,D
Mailing Address - Street 1:160 SUMMERFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-2201
Mailing Address - Country:US
Mailing Address - Phone:706-495-1756
Mailing Address - Fax:
Practice Address - Street 1:160 SUMMERFIELD CIR
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-2201
Practice Address - Country:US
Practice Address - Phone:706-495-1756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH-0243931835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist