Individual
TARA LENORE SALCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 773-2120
(928) 773-2189
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
AP5130
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
860171
—
AZ
Enumeration date
06/26/2013
Last updated
04/03/2017
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