Provider Demographics
NPI:1720481161
Name:JAMES, SELINA UKIMMY (LPN)
Entity Type:Individual
Prefix:MISS
First Name:SELINA
Middle Name:UKIMMY
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-19 190TH STREET
Mailing Address - Street 2:APT 3
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423
Mailing Address - Country:US
Mailing Address - Phone:718-679-0059
Mailing Address - Fax:
Practice Address - Street 1:92-19 190TH STREET
Practice Address - Street 2:APT 3
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423
Practice Address - Country:US
Practice Address - Phone:718-679-0059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10 2931243747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider