Provider Demographics
NPI:1558257998
Name:SALAZAR, GENESIS NICOLE
Entity type:Individual
Prefix:
First Name:GENESIS
Middle Name:NICOLE
Last Name:SALAZAR
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:HC 4 BOX 12785
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-9592
Mailing Address - Country:US
Mailing Address - Phone:939-249-9091
Mailing Address - Fax:
Practice Address - Street 1:HC 4 BOX 12785
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9592
Practice Address - Country:US
Practice Address - Phone:939-249-9091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program