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NPI Code Detail

MEDICARE: TRACY SALEM RN, NP

MEDICARE: TRACY SALEM RN, NP
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
1363LA2200XAdult Health Nurse PractitionerAP2616AZ
2363LG0600XGerontology Nurse PractitionerAP2616AZ
3363L00000XNurse PractitionerAP2616AZ

General Provider Information

NPI Number : 1467508275
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY SALEM RN, NP
Provider Business Mailing Address
First Line : 8206 N VIA DE LAGO
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4214
Country : US
Telephone Number : 480-734-4047
Fax Number :
Provider Business Practice Location Address
First Line : 7400 E THOMPSON PEAK PKWY
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85255-4109
Country : US
Telephone Number : 602-292-3404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 09/29/2023

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