| Katrina Lea Selsor, NP | |
|
155 Village Dr, Sparta, MO 65753-8104 | |
| (417) 634-4203 | |
| (417) 634-4505 |
| Full Name | Katrina Lea Selsor |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 9 Years |
| Location | 155 Village Dr, Sparta, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073020673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP2300X | Nurse Practitioner - Primary Care | 2018000302 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ozarks Community Hospital Of Gravette | Gravette, AR | Hospital |
| Mercy Hospital Springfield | Springfield, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sgoh Acquisition Inc | 5092616276 | 74 |
| Entity Name | Sgoh Acquisition Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114924768 PECOS PAC ID: 5092616276 Enrollment ID: O20040205000647 |
| Mailing Address | Practice Location Address |
|---|---|
| Katrina Lea Selsor, NP 2183 Johnson Rd, Sparta, MO 65753-8813 Ph: (417) 880-2505 | Katrina Lea Selsor, NP 155 Village Dr, Sparta, MO 65753-8104 Ph: (417) 634-4203 |
Tara N Loveland, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 155 Village Dr, Sparta, MO 65753 Phone: 417-634-4203 Fax: 417-634-4505 | |
Taylor Lauren Heath, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 155 Village Dr, Sparta, MO 65753 Phone: 417-634-4203 | |
Bryan L. Logan, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 155 Village Drive, Sparta, MO 65673 Phone: 417-634-4203 Fax: 417-634-4505 |