Healthcare Provider Details

I. General information

NPI: 1255453379
Provider Name (Legal Business Name): NAITA LYDIA SALMON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 04/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 STRAND ST
FREDERIKSTED VI
00840-3533
US

IV. Provider business mailing address

6044 QUESTA VERDE #J44
CHRISTIANSTED VI
00820-5101
US

V. Phone/Fax

Practice location:
  • Phone: 340-772-0260
  • Fax: 340-713-3215
Mailing address:
  • Phone: 340-772-0260
  • Fax: 340-713-3215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9169
License Number StateVI
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number9169
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: