Basic Information
| Provider Information | |||||||||
| NPI: | 1851367197 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALVAGGIO | ||||||||
| FirstName: | KAREN | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 720 | ||||||||
| Address2: | |||||||||
| City: | BOLIVAR | ||||||||
| State: | TN | ||||||||
| PostalCode: | 380080720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7316593125 | ||||||||
| FaxNumber: | 7316593131 | ||||||||
| Practice Location | |||||||||
| Address1: | 629 NUCKOLLS RD | ||||||||
| Address2: | |||||||||
| City: | BOLIVAR | ||||||||
| State: | TN | ||||||||
| PostalCode: | 380081599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7316583388 | ||||||||
| FaxNumber: | 7316584079 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2006 | ||||||||
| LastUpdateDate: | 09/27/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | RN81212 | TN | N | Nursing Service Providers | Registered Nurse | General Practice | 363LF0000X | APN6367 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.