MEDICARE: KATELYNN AMBER PICABO SALYAN

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	363LF0000X	Family Nurse Practitioner	APRN.CNP.0041705	OH

General Provider Information

NPI Number	:	1487500526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYNN AMBER PICABO SALYAN

Provider Business Mailing Address
First Line	:	531 5TH AVE
Second Line	:
City	:	CHARDON
State	:	OH
Zip	:	44024-1088
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	531 5TH AVE
Second Line	:
City	:	CHARDON
State	:	OH
Zip	:	44024-1088
Country	:	US
Telephone Number	:	440-285-2300
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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