Healthcare Provider Details

I. General information

NPI: 1811559610
Provider Name (Legal Business Name): MELISSA J SALTER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 LOWTHER ST
LEMOYNE PA
17043-2045
US

IV. Provider business mailing address

5622 AMBAU RD
SPRING GROVE PA
17362-7501
US

V. Phone/Fax

Practice location:
  • Phone: 717-774-1366
  • Fax:
Mailing address:
  • Phone: 717-309-5706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP020450
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN634766
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: