Provider Demographics
NPI:1194177691
Name:SALAMEH, TRACY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:SALAMEH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 E 54TH ST N
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-0641
Mailing Address - Country:US
Mailing Address - Phone:605-940-8098
Mailing Address - Fax:
Practice Address - Street 1:620 E 54TH ST N
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-0641
Practice Address - Country:US
Practice Address - Phone:605-940-8098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP001079363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner