Provider Demographics
NPI:1962123869
Name:SALISBURY, ANNETTE MARIE (LPN)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MARIE
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MELVIN AVE
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-5209
Mailing Address - Country:US
Mailing Address - Phone:480-743-8255
Mailing Address - Fax:
Practice Address - Street 1:101 MELVIN AVE
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-5209
Practice Address - Country:US
Practice Address - Phone:480-743-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334267164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse