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NPI Code Detail

MEDICARE: ANDREA ELOISA SALCEDO ACAGNP-BC RN

MEDICARE: ANDREA ELOISA SALCEDO ACAGNP-BC RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse PractitionerAP1455945TX

General Provider Information

NPI Number : 1023630977
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA ELOISA SALCEDO ACAGNP-BC RN
Provider Business Mailing Address
First Line : 11428 LAKE NEMI DR
Second Line :
City : EL PASO
State : TX
Zip : 79936-3953
Country : US
Telephone Number : 915-433-7649
Fax Number :
Provider Business Practice Location Address
First Line : 1205 N OREGON ST
Second Line :
City : EL PASO
State : TX
Zip : 79902-4023
Country : US
Telephone Number : 915-533-4900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2020
Last Update Date : 05/14/2020

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