Provider Demographics
NPI:1831079383
Name:SELBY, SHAQUAY
Entity type:Individual
Prefix:
First Name:SHAQUAY
Middle Name:
Last Name:SELBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 W MICHIGAN AVE UNIT 224
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1302
Mailing Address - Country:US
Mailing Address - Phone:484-402-6529
Mailing Address - Fax:517-905-5912
Practice Address - Street 1:156 W MICHIGAN AVE UNIT 224
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1302
Practice Address - Country:US
Practice Address - Phone:484-402-6529
Practice Address - Fax:517-905-5912
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula