Provider Demographics
NPI:1447050265
Name:BARBA-SALLOUM, MARISELA (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:MARISELA
Middle Name:
Last Name:BARBA-SALLOUM
Suffix:
Gender:
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 WESTWIND DR STE 145
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1758
Mailing Address - Country:US
Mailing Address - Phone:915-740-2111
Mailing Address - Fax:
Practice Address - Street 1:7100 WESTWIND DR STE 145
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1758
Practice Address - Country:US
Practice Address - Phone:915-740-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1192392363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health