Provider Demographics
NPI:1992483135
Name:NJOTU, SELOPHINE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:SELOPHINE
Middle Name:
Last Name:NJOTU
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2663 WATERFRONT DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-7201
Mailing Address - Country:US
Mailing Address - Phone:817-793-4614
Mailing Address - Fax:
Practice Address - Street 1:6404 INTERNATIONAL PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8225
Practice Address - Country:US
Practice Address - Phone:817-793-4614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX732552363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health