Healthcare Provider Details

I. General information

NPI: 1033555644
Provider Name (Legal Business Name): CHRISTINE A SALEM CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HIGH ST STE B
WORTHINGTON OH
43085-4093
US

IV. Provider business mailing address

1000 HIGH ST STE B
WORTHINGTON OH
43085-4093
US

V. Phone/Fax

Practice location:
  • Phone: 614-858-8922
  • Fax: 614-807-2373
Mailing address:
  • Phone: 614-858-8922
  • Fax: 614-807-2373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number358718
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.14672-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: