Healthcare Provider Details

I. General information

NPI: 1003337981
Provider Name (Legal Business Name): SARAH LYNN SALCE DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S THOMPSON ST
FLAGSTAFF AZ
86001-8759
US

IV. Provider business mailing address

1200 N BEAVER ST
FLAGSTAFF AZ
86001-3118
US

V. Phone/Fax

Practice location:
  • Phone: 928-226-6400
  • Fax: 928-226-6401
Mailing address:
  • Phone: 928-213-6235
  • Fax: 928-213-6292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number60776635
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number219445
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: