Provider Demographics
NPI:1255453379
Name:SALMON, NAITA LYDIA (NP)
Entity type:Individual
Prefix:MS
First Name:NAITA
Middle Name:LYDIA
Last Name:SALMON
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 1:6044 QUESTA VERDE #J44
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-5101
Mailing Address - Country:US
Mailing Address - Phone:340-772-0260
Mailing Address - Fax:340-713-3215
Practice Address - Street 1:516 STRAND ST
Practice Address - Street 2:
Practice Address - City:FREDERIKSTED
Practice Address - State:VI
Practice Address - Zip Code:00840-3533
Practice Address - Country:US
Practice Address - Phone:340-772-0260
Practice Address - Fax:340-713-3215
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2015-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI9169363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health