Provider Demographics
NPI:1861263824
Name:SALMON- SANDERS, KADIA CAMANA
Entity type:Individual
Prefix:MISS
First Name:KADIA
Middle Name:CAMANA
Last Name:SALMON- SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KADIA
Other - Middle Name:CAMANA
Other - Last Name:SALMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 BUTTONWOOD RD APT D
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-5285
Mailing Address - Country:US
Mailing Address - Phone:845-309-2082
Mailing Address - Fax:
Practice Address - Street 1:23 BUTTONWOOD RD APT D
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-5285
Practice Address - Country:US
Practice Address - Phone:845-309-2082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342690164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse