Healthcare Provider Details

I. General information

NPI: 1629052816
Provider Name (Legal Business Name): ADRIENNE NOELLE SALANECK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 PHILADELPHIA AVE
SHILLINGTON PA
19607-2757
US

IV. Provider business mailing address

14 PHILADELPHIA AVE
SHILLINGTON PA
19607-2757
US

V. Phone/Fax

Practice location:
  • Phone: 610-871-3856
  • Fax: 610-871-7889
Mailing address:
  • Phone: 610-871-3856
  • Fax: 610-871-7889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP008858
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP008858
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: