Provider Demographics
NPI:1578109880
Name:SAYGER, SALLI MICHELLE
Entity Type:Individual
Prefix:
First Name:SALLI
Middle Name:MICHELLE
Last Name:SAYGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 COUNTY ROAD 400L
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:TX
Mailing Address - Zip Code:79360
Mailing Address - Country:US
Mailing Address - Phone:870-415-9030
Mailing Address - Fax:
Practice Address - Street 1:241 COUNTY ROAD 400L
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:TX
Practice Address - Zip Code:79360
Practice Address - Country:US
Practice Address - Phone:870-415-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX905643163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse