Provider Demographics
NPI:1164219333
Name:SALMON, SHERLINE LAINE SALMON (CNA)
Entity type:Individual
Prefix:
First Name:SHERLINE
Middle Name:LAINE SALMON
Last Name:SALMON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 ORISTA DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33897-9542
Mailing Address - Country:US
Mailing Address - Phone:407-502-9798
Mailing Address - Fax:
Practice Address - Street 1:366 ORISTA DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33897-9542
Practice Address - Country:US
Practice Address - Phone:407-502-9798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747A0650X, 374T00000X, 376G00000X, 311ZA0620X
FLCNA372924374U00000X, 376K00000X
FL171245510376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel
No374U00000XNursing Service Related ProvidersHome Health Aide
No376G00000XNursing Service Related ProvidersNursing Home Administrator
No376K00000XNursing Service Related ProvidersNurse's Aide