Provider Demographics
NPI:1558934042
Name:ROBLES SALAZAR, ANA LAURA (RN)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:LAURA
Last Name:ROBLES SALAZAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S7559 US HIGHWAY 12 LOT K-7
Mailing Address - Street 2:
Mailing Address - City:NORTH FREEDOM
Mailing Address - State:WI
Mailing Address - Zip Code:53951-9722
Mailing Address - Country:US
Mailing Address - Phone:608-393-0830
Mailing Address - Fax:
Practice Address - Street 1:2600 SW HOLDEN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3505
Practice Address - Country:US
Practice Address - Phone:206-933-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI261428163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse