Provider Demographics
NPI:1689269623
Name:SALAZAR, SHALAILA ANN (ACNPC-AG)
Entity Type:Individual
Prefix:MRS
First Name:SHALAILA
Middle Name:ANN
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 POCOSIN RD
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-8525
Mailing Address - Country:US
Mailing Address - Phone:252-417-8969
Mailing Address - Fax:
Practice Address - Street 1:726 POCOSIN RD
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8525
Practice Address - Country:US
Practice Address - Phone:252-417-8969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCSALA-UHJ45363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care