Healthcare Provider Details

I. General information

NPI: 1164334488
Provider Name (Legal Business Name): SUE SALISBURY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 ULULANI ST
KULA HI
96790-8930
US

IV. Provider business mailing address

43 ULULANI ST
KULA HI
96790-8930
US

V. Phone/Fax

Practice location:
  • Phone: 808-269-6627
  • Fax: 808-878-8376
Mailing address:
  • Phone: 808-269-6627
  • Fax: 808-878-8376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-24674
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: