Provider Demographics
NPI:1548807563
Name:RUBAINE, SELMA (RN)
Entity type:Individual
Prefix:
First Name:SELMA
Middle Name:
Last Name:RUBAINE
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:PO BOX 10493
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-3493
Mailing Address - Country:US
Mailing Address - Phone:340-642-8842
Mailing Address - Fax:
Practice Address - Street 1:9150 ESTATE THOMAS STE 108
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2612
Practice Address - Country:US
Practice Address - Phone:340-642-8842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI9668163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health