Provider Demographics
NPI:1669988010
Name:ELLIOTT-SALMON, NAOMI KARLENE
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:KARLENE
Last Name:ELLIOTT-SALMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 FURLONG DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-8393
Mailing Address - Country:US
Mailing Address - Phone:972-464-8430
Mailing Address - Fax:
Practice Address - Street 1:963 FURLONG DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8393
Practice Address - Country:US
Practice Address - Phone:972-464-8430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide