Individual
JEREMY M SALSBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(316) 268-5000
Mailing address
PO BOX 356, WICHITA, KS 67201-0356
(800) 374-5326
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1387362102
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
55674
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200574090A
—
KS
01
—
D024
TRICARE 4811589767214
KS
01
—
P00727377
RR MEDICARE GROUP CQ2302
KS
Enumeration date
07/11/2008
Last updated
10/28/2009
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