Provider Demographics
NPI:1669403010
Name:SELDEN, ELAINE MARIE HARLAN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:MARIE HARLAN
Last Name:SELDEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8131 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50325-1123
Mailing Address - Country:US
Mailing Address - Phone:515-225-8180
Mailing Address - Fax:515-225-2041
Practice Address - Street 1:8131 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50325-1123
Practice Address - Country:US
Practice Address - Phone:515-225-8180
Practice Address - Fax:515-225-2041
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA058855363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP11805Medicare UPIN
I0057Medicare PIN