Provider Demographics
NPI:1851507354
Name:SALOPEK, PHYLLIS GAYLE (FNP)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:GAYLE
Last Name:SALOPEK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 W 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2513
Mailing Address - Country:US
Mailing Address - Phone:530-518-8497
Mailing Address - Fax:
Practice Address - Street 1:2445 CARMICHAEL DR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-7132
Practice Address - Country:US
Practice Address - Phone:530-879-3665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA451951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily