Provider Demographics
NPI:1912334269
Name:SELAH, JULIA O (ANP-BC)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:O
Last Name:SELAH
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:797 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4611
Mailing Address - Country:US
Mailing Address - Phone:703-216-0712
Mailing Address - Fax:
Practice Address - Street 1:NATIONAL INSTITUTES OF HEALTH
Practice Address - Street 2:10 CENTER DRIVE, BLDG.10, ROOM B1N264B6
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-594-6780
Practice Address - Fax:301-480-1144
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001082927163W00000X
MDAC000895363LA2200X
DC43498363LA2200X
VA0024082927363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0276493OtherANCC CERTIFICATION NUMBER