Healthcare Provider Details

I. General information

NPI: 1447379276
Provider Name (Legal Business Name): CHERI SALAZAR CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13750 S SEDONA PKWY STE 2
LANSING MI
48906-8101
US

IV. Provider business mailing address

3901 BEAUBIEN CHM - NEUROSURGERY
DETROIT MI
48201
US

V. Phone/Fax

Practice location:
  • Phone: 517-353-4000
  • Fax: 844-722-4112
Mailing address:
  • Phone: 313-833-4490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704229900
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: