Provider Demographics
NPI:1326931304
Name:SALTER, ELISE PAULINE (RN)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:PAULINE
Last Name:SALTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-1669
Mailing Address - Country:US
Mailing Address - Phone:217-213-7093
Mailing Address - Fax:
Practice Address - Street 1:404 W 9TH ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:IL
Practice Address - Zip Code:61846-1419
Practice Address - Country:US
Practice Address - Phone:812-229-0492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.419551163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse