Provider Demographics
NPI:1447416474
Name:SALITIS, KELLY ANN (RN)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:SALITIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ANN
Other - Last Name:COLLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:15 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-9090
Mailing Address - Country:US
Mailing Address - Phone:570-674-4033
Mailing Address - Fax:
Practice Address - Street 1:15 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-9090
Practice Address - Country:US
Practice Address - Phone:570-674-4033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN522801L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse