MEDICARE: TRENIA SLAYDEN APRN

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	APRN11028793	FL
2	363L00000X	Nurse Practitioner	APRN11028793	FL

General Provider Information

NPI Number	:	1619727229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRENIA SLAYDEN APRN

Provider Business Mailing Address
First Line	:	3716 W OAKLAND PARK BLVD
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33311-1134
Country	:	US
Telephone Number	:	954-759-7557
Fax Number	:	954-733-9155

Provider Business Practice Location Address
First Line	:	3716 W OAKLAND PARK BLVD
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33311-1134
Country	:	US
Telephone Number	:	954-759-7557
Fax Number	:	954-733-9155

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

Provider Enumeration Date	:	03/26/2024
Last Update Date	:	06/27/2024

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Directions to “ TRENIA SLAYDEN APRN” Practice Location

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