Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Selene Ingraham, APRN

Individual provider Family Nurse Practitioner · NPI 1780577189

Selene Ingraham, APRN is a Nurse Practitioner in Provo, Utah. Qualified in 2024, 2 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
2
Licensed in
UT
In the registry since
2025
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

1055 N 500 W Ste 201 Bldg C
Provo, UT 84604
Phone: (801) 429-8000
Fax: (801) 429-8150
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 221 S 2800 E, Spanish Fork, UT 84660-6514 — (801) 669-4656

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 8513908-4405 (UT)

Record details

NPI number1780577189
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorYes
NPI enumeratedJune 3, 2025
Last updated in NPPESJune 20, 2025
Certification dateJune 20, 2025
Mailing address1055 N 500 W, Attn Credentialing, Provo, UT 84604

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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