Provider Demographics
NPI:1235413923
Name:SALAZAR, JAMES PHILLIP (PMHNP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PHILLIP
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1161 MALL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8193
Mailing Address - Country:US
Mailing Address - Phone:575-522-2330
Mailing Address - Fax:575-522-2344
Practice Address - Street 1:1161 MALL DR
Practice Address - Street 2:SUITE C
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8193
Practice Address - Country:US
Practice Address - Phone:575-522-2330
Practice Address - Fax:575-522-2344
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMCNP-01854363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health