Healthcare Provider Details

I. General information

NPI: 1699095216
Provider Name (Legal Business Name): MS. VERONA SLADE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 02/22/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 S 600 E
SALT LAKE CITY UT
84102-1007
US

IV. Provider business mailing address

189 PLUMTREE LN APT 5G
MIDVALE UT
84047-1133
US

V. Phone/Fax

Practice location:
  • Phone: 801-428-3461
  • Fax:
Mailing address:
  • Phone: 801-069-6775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number015720808
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: