MEDICARE: ERIC SALSER CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	147707	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033187638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC SALSER CRNA

Provider Business Mailing Address
First Line	:	PO BOX 207
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38101-0207
Country	:	US
Telephone Number	:	813-287-5718
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 W BADDOUR PKWY
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-2513
Country	:	US
Telephone Number	:	615-256-1064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	11/10/2011

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