Healthcare Provider Details

I. General information

NPI: 1972783678
Provider Name (Legal Business Name): BARBARA SALAS CNP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 SECOND STREET
SANTA FE NM
87505
US

IV. Provider business mailing address

1428 SECOND STREET
SANTA FE NM
87505
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-2991
  • Fax: 505-982-4508
Mailing address:
  • Phone: 505-982-2991
  • Fax: 505-982-4508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR23147
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR23147
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR23147
License Number StateNM

VIII. Authorized Official

Name: MS. BARBARA R SALAS
Title or Position: OWNER
Credential: CNP
Phone: 505-982-2991