Provider Demographics
NPI:1265183057
Name:ARMSTRONG, SELENA NICOLE (FNP-BC)
Entity type:Individual
Prefix:
First Name:SELENA
Middle Name:NICOLE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 COUNTY ROAD 57
Mailing Address - Street 2:
Mailing Address - City:DENNIS
Mailing Address - State:MS
Mailing Address - Zip Code:38838-9504
Mailing Address - Country:US
Mailing Address - Phone:662-279-1836
Mailing Address - Fax:
Practice Address - Street 1:1424 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-2956
Practice Address - Country:US
Practice Address - Phone:662-350-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904877363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily