Provider Demographics
NPI:1942832266
Name:SALO, JANELLE R (RN)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:R
Last Name:SALO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4061 POWDER MILL RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CALVERTON
Mailing Address - State:MD
Mailing Address - Zip Code:20705-4037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4061 POWDER MILL RD STE 500
Practice Address - Street 2:
Practice Address - City:CALVERTON
Practice Address - State:MD
Practice Address - Zip Code:20705-4037
Practice Address - Country:US
Practice Address - Phone:301-931-6137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR180874163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse