Provider Demographics
NPI:1629052816
Name:SALANECK, ADRIENNE NOELLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:NOELLE
Last Name:SALANECK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2757
Mailing Address - Country:US
Mailing Address - Phone:610-871-3856
Mailing Address - Fax:610-871-7889
Practice Address - Street 1:14 PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-2757
Practice Address - Country:US
Practice Address - Phone:610-871-3856
Practice Address - Fax:610-871-7889
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008858363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102579995Medicaid