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General NPI Number Information
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NPI Number | 1447942891
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Entity Type | Organization
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Legal Business Name | WILLIAM JAY SALLS LLC
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 36 WINDMILL RD
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City | QUESTA
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State | NM
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Zip | 87556-0638
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Country | US
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Telephone | 575-586-2014
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 638
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City | QUESTA
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State | NM
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Zip | 87556-0638
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Country | US
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Telephone | 575-586-2014
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM JAY SALLS
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Credential | NURSE PRACTITIONER
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Telephone | 575-770-6865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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