Healthcare Provider Details

I. General information

NPI: 1477986032
Provider Name (Legal Business Name): KALEI ENSMINGER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2013
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 LAFAYETTE ST
SALEM MA
01970-5348
US

IV. Provider business mailing address

352 LAFAYETTE ST
SALEM MA
01970-5348
US

V. Phone/Fax

Practice location:
  • Phone: 978-542-6551
  • Fax:
Mailing address:
  • Phone: 978-542-6410
  • Fax: 978-542-7121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2277445
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: