Individual
WILLIAM JAY SALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
36 SOUTH LATIR ROAD, QUESTA, NM 87556
(575) 770-6865
(833) 450-5253
Mailing address
PO BOX 638, QUESTA, NM 87556-0638
(575) 586-2014
(833) 450-5253
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
C-APN.0000331-C-NP
CO
363LF0000X
Family Nurse Practitioner
Primary
CNP-02608
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71978828
—
NM
Enumeration date
09/14/2012
Last updated
04/22/2025
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