Healthcare Provider Details

I. General information

NPI: 1366359242
Provider Name (Legal Business Name): SIRLEY A SALAZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W MAIN ST
RICHMOND IN
47374-3882
US

IV. Provider business mailing address

2200 W MAIN ST
RICHMOND IN
47374-3882
US

V. Phone/Fax

Practice location:
  • Phone: 765-973-9294
  • Fax: 765-973-9233
Mailing address:
  • Phone: 765-973-9294
  • Fax: 765-973-9233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28231304C
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: