Healthcare Provider Details

I. General information

NPI: 1831578343
Provider Name (Legal Business Name): HEATHER SALAZAR FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2015
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 ALONDRA RD
SANTA FE NM
87508-8701
US

IV. Provider business mailing address

6 ALONDRA RD
SANTA FE NM
87508-8701
US

V. Phone/Fax

Practice location:
  • Phone: 505-699-3268
  • Fax:
Mailing address:
  • Phone: 505-699-3268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-02668
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberCNP-02668
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: