Provider Demographics
NPI:1396537775
Name:SALPAS, MACEY JO
Entity type:Individual
Prefix:
First Name:MACEY
Middle Name:JO
Last Name:SALPAS
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 1:1722 RAINBOW RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-1815
Mailing Address - Country:US
Mailing Address - Phone:308-385-8795
Mailing Address - Fax:
Practice Address - Street 1:3611 L AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-3270
Practice Address - Country:US
Practice Address - Phone:308-385-8795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant