Provider Demographics
NPI:1376920306
Name:SALEMI, KIERSTEN HALI (LPN)
Entity Type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:HALI
Last Name:SALEMI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 STATE ROUTE 5 LOT 21
Mailing Address - Street 2:
Mailing Address - City:ELBRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:13060-9655
Mailing Address - Country:US
Mailing Address - Phone:315-406-8802
Mailing Address - Fax:
Practice Address - Street 1:1275 STATE ROUTE 5 LOT 21
Practice Address - Street 2:
Practice Address - City:ELBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:13060-9655
Practice Address - Country:US
Practice Address - Phone:315-406-8802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312057-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse