Healthcare Provider Details

I. General information

NPI: 1033187638
Provider Name (Legal Business Name): ERIC BROOKS SALSER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 W BADDOUR PKWY
LEBANON TN
37087-2513
US

IV. Provider business mailing address

PO BOX 207
MEMPHIS TN
38101-0207
US

V. Phone/Fax

Practice location:
  • Phone: 615-256-1064
  • Fax:
Mailing address:
  • Phone: 813-287-5718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number147707
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number307016
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: