Healthcare Provider Details

I. General information

NPI: 1538727888
Provider Name (Legal Business Name): KALI ANNE SAULSBURY RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALI ANNE SHAROT RN, CNP

II. Dates (important events)

Enumeration Date: 06/02/2019
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 WASHINGTON DRIVE SUITE 200
EAGAN MN
55122-1339
US

IV. Provider business mailing address

2497 7TH AVENUE E. SUITE 108
NORTH ST PAUL MN
55109-2946
US

V. Phone/Fax

Practice location:
  • Phone: 612-769-6200
  • Fax: 651-769-6249
Mailing address:
  • Phone: 651-769-6437
  • Fax: 651-769-6599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number190179-30
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number7454
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: