Provider Demographics
NPI:1417392069
Name:SALFER, MAVIS KAY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MAVIS
Middle Name:KAY
Last Name:SALFER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 E BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283-1664
Mailing Address - Country:US
Mailing Address - Phone:507-637-4041
Mailing Address - Fax:507-637-4046
Practice Address - Street 1:266 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283-1664
Practice Address - Country:US
Practice Address - Phone:507-637-4041
Practice Address - Fax:507-637-4046
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL 53402-6164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse