Provider Demographics
NPI:1407895097
Name:SALGADO, VIVIAN (NP)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:
Last Name:SALGADO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 N. WYATT DRIVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:520-545-0608
Mailing Address - Fax:520-795-0354
Practice Address - Street 1:5750 E. HIGHWAY 90
Practice Address - Street 2:SUITE 300A
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635
Practice Address - Country:US
Practice Address - Phone:520-458-8075
Practice Address - Fax:520-458-0339
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ063922163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
2Z2375OtherHEALTHNET
AZ319451Medicaid
AZ319451Medicaid
AZZ104696Medicare PIN
AZZ105253Medicare PIN
2Z2375OtherHEALTHNET