Provider Demographics
NPI:1043692064
Name:SALINAS, LOURDES
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:
Last Name:SALINAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-3217
Mailing Address - Country:US
Mailing Address - Phone:313-515-5731
Mailing Address - Fax:
Practice Address - Street 1:1624 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-3217
Practice Address - Country:US
Practice Address - Phone:313-515-5731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion