Healthcare Provider Details

I. General information

NPI: 1376452573
Provider Name (Legal Business Name): HEATHER ELIZABETH SLATTERY WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 BROADWAY
CAMDEN NJ
08103-1253
US

IV. Provider business mailing address

607 W 19TH ST
WILMINGTON DE
19802-3904
US

V. Phone/Fax

Practice location:
  • Phone: 833-377-8474
  • Fax:
Mailing address:
  • Phone: 848-404-6029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ15649200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: