Provider Demographics
NPI:1114758257
Name:SALVO, LEYLA MARIE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:LEYLA
Middle Name:MARIE
Last Name:SALVO
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 CAPITAN RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-0560
Mailing Address - Country:US
Mailing Address - Phone:724-833-4601
Mailing Address - Fax:
Practice Address - Street 1:475 CAPITAN RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-0560
Practice Address - Country:US
Practice Address - Phone:724-833-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-10
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NML-310198163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant