Basic Information
| Provider Information | |||||||||
| NPI: | 1811559610 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALTER | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5622 AMBAU RD | ||||||||
| Address2: | |||||||||
| City: | SPRING GROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173627501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173095706 | ||||||||
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| Practice Location | |||||||||
| Address1: | 108 LOWTHER ST | ||||||||
| Address2: | |||||||||
| City: | LEMOYNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170432045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177741366 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2019 | ||||||||
| LastUpdateDate: | 07/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN634766 | PA | N | Nursing Service Providers | Registered Nurse | 363LF0000X | SP020450 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.