Provider Demographics
NPI:1891210712
Name:SELLERS, PARIS A R (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:PARIS
Middle Name:A R
Last Name:SELLERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 GRAYSTONE PL SE STE 202
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8269
Mailing Address - Country:US
Mailing Address - Phone:828-732-5700
Mailing Address - Fax:828-732-5701
Practice Address - Street 1:3521 GRAYSTONE PL SE STE 202
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8269
Practice Address - Country:US
Practice Address - Phone:828-732-5700
Practice Address - Fax:828-732-5701
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07549363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTL3114OtherSC LICENSE