Healthcare Provider Details

I. General information

NPI: 1689082422
Provider Name (Legal Business Name): JUSTINE E SLAVIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUSTINE E FRIEL

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 SEVENTH ST
NEW KENSINGTON PA
15068-6529
US

IV. Provider business mailing address

305 SEVENTH ST
NEW KENSINGTON PA
15068-6529
US

V. Phone/Fax

Practice location:
  • Phone: 724-339-3900
  • Fax: 724-334-1704
Mailing address:
  • Phone: 724-339-3900
  • Fax: 724-334-1704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013859
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: