Provider Demographics
NPI:1821371923
Name:CLOW, SELINA CZERWINSKI (NP-C)
Entity Type:Individual
Prefix:
First Name:SELINA
Middle Name:CZERWINSKI
Last Name:CLOW
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 KEY PLZ # 417
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4077
Mailing Address - Country:US
Mailing Address - Phone:410-905-3894
Mailing Address - Fax:
Practice Address - Street 1:770 10TH ST
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6210
Practice Address - Country:US
Practice Address - Phone:707-826-8610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-25
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9334752363LF0000X
CA95012186363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily