Provider Demographics
NPI:1962905836
Name:SELMAN, STACY LYNN (RN)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:LYNN
Last Name:SELMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 WHISPERING PINE LN
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-3178
Mailing Address - Country:US
Mailing Address - Phone:936-208-5531
Mailing Address - Fax:
Practice Address - Street 1:133 WHISPERING PINE LN
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-3178
Practice Address - Country:US
Practice Address - Phone:936-208-5531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX926324163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX926324OtherTEXAS BOARD OF NURSING