Provider Demographics
NPI:1215255039
Name:ACOSTA-SALCEDO, ILEANA MARGARITA (RN)
Entity type:Individual
Prefix:MRS
First Name:ILEANA
Middle Name:MARGARITA
Last Name:ACOSTA-SALCEDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ILEANA
Other - Middle Name:MARGARITA
Other - Last Name:ACOSTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:CMR 464 BOX 2014
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09226
Mailing Address - Country:US
Mailing Address - Phone:499721-475-9889
Mailing Address - Fax:
Practice Address - Street 1:USA MEDDAC BAVARIA
Practice Address - Street 2:CMR 411, BLDG 700, ROSE BARRACKS
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09033
Practice Address - Country:US
Practice Address - Phone:49966-283-4719
Practice Address - Fax:49966-283-4721
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00669163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000OtherUPIN