Provider Demographics
NPI:1356740112
Name:SALERNO, SANTINA M (NP)
Entity type:Individual
Prefix:MRS
First Name:SANTINA
Middle Name:M
Last Name:SALERNO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 CAPRON FARM DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7700
Mailing Address - Country:US
Mailing Address - Phone:207-837-9622
Mailing Address - Fax:
Practice Address - Street 1:PROVIDENCE VA MEDICAL CENTER
Practice Address - Street 2:830 CHALKSTONE AVE
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908
Practice Address - Country:US
Practice Address - Phone:401-027-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2293743363LF0000X
RIAPRN00977363LP0808X
RINPP37908363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health