MEDICARE: ALICIA NOEL SALLOT APRN-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	LE00031884	OH

General Provider Information

NPI Number	:	1063036580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA NOEL SALLOT APRN-C

Provider Business Mailing Address
First Line	:	1621 S MAIN ST
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-1320
Country	:	US
Telephone Number	:	419-306-5283
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 CHAPEL DR STE C
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-1344
Country	:	US
Telephone Number	:	425-564-6419
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2020
Last Update Date	:	06/05/2026

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