Provider Demographics
NPI:1326759952
Name:SALTER, KRISTIN J (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:J
Last Name:SALTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:224 D CORNWALL STREET NW, SUITE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:20 TOWN SQUARE, SUITE 180
Practice Address - Street 2:
Practice Address - City:LOVETTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20180-8558
Practice Address - Country:US
Practice Address - Phone:540-579-0500
Practice Address - Fax:540-822-5036
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1326759952Medicaid
VA30017586160001Medicaid