Provider Demographics
NPI:1386479863
Name:SELHORST, ANGEL MARIE
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:MARIE
Last Name:SELHORST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGEL
Other - Middle Name:
Other - Last Name:ONCAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:614 CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-2485
Mailing Address - Country:US
Mailing Address - Phone:419-733-0512
Mailing Address - Fax:
Practice Address - Street 1:614 CATHERINE ST
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-2485
Practice Address - Country:US
Practice Address - Phone:419-733-0512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide