| Doctor Name: | TRACY ANN SELHORST |
| NPI Number: | 1356755243 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | COA.15968-NP |
| Business Practice Address: | 1251 Lincoln Hwy Suite 1 Wapakoneta, OH - 458957356 |
| Business Phone Number: | 4197385151 |
| Business Fax Number: | 4199411092 |
| Mailing Address: | 951 Commerce Pkwy, Suite 101 LIMA |
| State: | OH |
| Postal Code: | 458044040 |
| Phone Number: | 4199984575 |
| Fax Number: | 4199984586 |
| NPI Enumeration Date: | 06/18/2014 |
| NPI Last Update Date: | 10/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | COA.15968-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |