Healthcare Provider Details

I. General information

NPI: 1609875459
Provider Name (Legal Business Name): MICHELLE JOY SLIDER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 E STATE ST SUITE B
SALEM OH
44460-4409
US

IV. Provider business mailing address

2525 SOUTHEAST BLVD
SALEM OH
44460-3464
US

V. Phone/Fax

Practice location:
  • Phone: 330-332-1939
  • Fax: 330-332-2233
Mailing address:
  • Phone: 330-332-1939
  • Fax: 330-332-2233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN-283664
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: