Provider Demographics
NPI:1942914056
Name:SALAZAR, VANESSA ALVINA (BSN RN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:ALVINA
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14835 N 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-3811
Mailing Address - Country:US
Mailing Address - Phone:858-229-8425
Mailing Address - Fax:
Practice Address - Street 1:5805 W ALAMEDA RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-3601
Practice Address - Country:US
Practice Address - Phone:623-445-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ233900163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool