MEDICARE: SARAH SALVAGGIO NP

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
1	363L00000X	Nurse Practitioner	4704311738	MI
2	363LF0000X	Family Nurse Practitioner	RN2266518	MA
3	363L00000X	Nurse Practitioner	5014394	NC

General Provider Information

NPI Number	:	1235532938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH SALVAGGIO NP

Provider Business Mailing Address
First Line	:	7070 E DRIVE NORTH
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-8562
Country	:	US
Telephone Number	:	269-660-1670
Fax Number	:	269-660-0666

Provider Business Practice Location Address
First Line	:	10502 PARK RD STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-6569
Country	:	US
Telephone Number	:	980-299-3926
Fax Number	:	980-299-6736

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2014
Last Update Date	:	06/10/2021

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