Basic Information
| Provider Information | |||||||||
| NPI: | 1700320595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALISBURY | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | STAR | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | AG-ACNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2800 BLUE RIDGE RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276076478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197875380 | ||||||||
| FaxNumber: | 9197873415 | ||||||||
| Practice Location | |||||||||
| Address1: | 2800 BLUE RIDGE RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276076478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197875380 | ||||||||
| FaxNumber: | 9197873415 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2016 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 5009167 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.