Provider Demographics
NPI:1891846127
Name:SALOMONE, ANNE W (RN-C, CNM)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:W
Last Name:SALOMONE
Suffix:
Gender:F
Credentials:RN-C, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 BURNING BUSH TRL
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60012-3618
Mailing Address - Country:US
Mailing Address - Phone:815-459-5563
Mailing Address - Fax:
Practice Address - Street 1:4119 W SHAMROCK LN
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8289
Practice Address - Country:US
Practice Address - Phone:815-344-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology