Provider Demographics
NPI:1649838624
Name:SELLERS, THERESA ANN (AP)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:ANN
Last Name:SELLERS
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112730
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32611-2730
Mailing Address - Country:US
Mailing Address - Phone:352-273-9860
Mailing Address - Fax:352-294-8035
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-2394
Practice Address - Country:US
Practice Address - Phone:352-273-9860
Practice Address - Fax:352-294-8035
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4495171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist