Healthcare Provider Details

I. General information

NPI: 1861304289
Provider Name (Legal Business Name): MICHAELA SLAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6417 NW HARLEY ST
BENTONVILLE AR
72713-4161
US

IV. Provider business mailing address

6417 NW HARLEY ST
BENTONVILLE AR
72713-4161
US

V. Phone/Fax

Practice location:
  • Phone: 615-653-3446
  • Fax:
Mailing address:
  • Phone: 615-653-3446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD17841
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: