Provider Demographics
NPI:1851367197
Name:SALVAGGIO, KAREN (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SALVAGGIO
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:PO BOX 720
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:TN
Mailing Address - Zip Code:38008-0720
Mailing Address - Country:US
Mailing Address - Phone:731-659-3125
Mailing Address - Fax:731-659-3131
Practice Address - Street 1:629 NUCKOLLS RD
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:TN
Practice Address - Zip Code:38008-1599
Practice Address - Country:US
Practice Address - Phone:731-658-3388
Practice Address - Fax:731-658-4079
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN81212163WG0000X
TNAPN6367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
S90393Medicare UPIN
TN3347337Medicare PIN