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General NPI Number Information
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NPI Number | 1770717795
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Entity Type | Individual
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Provider Name | KRISTIN JO LUSIAN SALINE D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/05/2009
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 4212 GRAND AVE ESSENTIA HEALTH WEST DULUTH CLINIC
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City | DULUTH
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State | MN
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Zip | 55807-2737
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Country | US
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Telephone | 218-786-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 2814 SNOWY OWL CIR
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City | DULUTH
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State | MN
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Zip | 55804-1189
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Country | US
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Telephone | 218-428-7355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 57448
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 53083
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License Number State | MN
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