Provider Demographics
NPI:1750322426
Name:SALISBURY, CHRISTINE (RN, BC, FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:RN, BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 CRIMSON LN
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-8499
Mailing Address - Country:US
Mailing Address - Phone:816-988-6460
Mailing Address - Fax:
Practice Address - Street 1:1616 N 7 HWY
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-1936
Practice Address - Country:US
Practice Address - Phone:816-228-6848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO079570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MON45C902Medicare ID - Type UnspecifiedPPG PROVIDER NUMBER