Healthcare Provider Details

I. General information

NPI: 1922087683
Provider Name (Legal Business Name): MARILYN E SLATER NPF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 COHASSET RD
CHICO CA
95926-2213
US

IV. Provider business mailing address

680 COHASSET RD
CHICO CA
95926-2213
US

V. Phone/Fax

Practice location:
  • Phone: 530-342-4395
  • Fax: 530-894-2325
Mailing address:
  • Phone: 530-342-4395
  • Fax: 530-894-2325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberFNP13302
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number505668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: