Provider Demographics
NPI:1083325815
Name:SALVAS, SHADA N (APRN)
Entity Type:Individual
Prefix:MS
First Name:SHADA
Middle Name:N
Last Name:SALVAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 BALDWIN DR S
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3655
Mailing Address - Country:US
Mailing Address - Phone:850-879-6437
Mailing Address - Fax:
Practice Address - Street 1:4012 KELCEY CT STE 103
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5986
Practice Address - Country:US
Practice Address - Phone:850-297-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023468363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily