MEDICARE: RHONDA KLUEG-SLATER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71000955A	IN
2	363L00000X	Nurse Practitioner	71000955A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01186100	OTHER	IN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000000806247	OTHER		ANTHEM

General Provider Information

NPI Number	:	1366492670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA KLUEG-SLATER NP

Provider Business Mailing Address
First Line	:	PO BOX 1510
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47706-1510
Country	:	US
Telephone Number	:	812-868-0530
Fax Number	:	812-868-2188

Provider Business Practice Location Address
First Line	:	1033 E MOUNT PLEASANT RD
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47725-7149
Country	:	US
Telephone Number	:	812-868-0530
Fax Number	:	812-868-2188

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	12/19/2014

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Directions to “ RHONDA KLUEG-SLATER NP” Practice Location

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