Provider Demographics
NPI:1437240462
Name:SALYER, SUSAN DIANE (ANP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:DIANE
Last Name:SALYER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 685106
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78768-5106
Mailing Address - Country:US
Mailing Address - Phone:512-797-5607
Mailing Address - Fax:
Practice Address - Street 1:1510 W 34TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1400
Practice Address - Country:US
Practice Address - Phone:512-306-0061
Practice Address - Fax:512-306-0069
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238685363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health