Individual
CASEY ELLEN SALAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 ROAD 1057, TUPELO, MS 38804-8224
(662) 214-2150
Mailing address
5335 TRIANGLE PKWY, PEACHTREE CORNERS, GA 30092-2599
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
858328
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
858328
RN CASE MANAGER
MS
Enumeration date
11/08/2022
Last updated
11/08/2022
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