Kacie Salas, RN, NC-BC

Individual provider Active NPI General Practice Registered Nurse · Calpine, CA

NPI 1972226470 · NPPES record last updated Sep 21, 2022

Key facts

NPI
1972226470
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
740061 (CA)
Practice address
221 Meadow Ranch Rd
Calpine, CA 96124
Phone
(530) 448-4272
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
740061CAMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 740061 CA Yes

Addresses

Primary practice location

221 Meadow Ranch Rd
Calpine, CA 96124

Mailing address

PO Box 302
Calpine, CA 96124-0302
Phone (530) 448-4272

Other identifiers

IdentifierTypeStateIssuer
RN74001OtherCACA STATE
740061OtherCANURSING LICENSE

Sources for this page

Verify at the official NPI Registry.