Healthcare Provider Details

I. General information

NPI: 1801817010
Provider Name (Legal Business Name): COREEN M SLOBIG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 S 38TH AVE
YAKIMA WA
98902-0000
US

IV. Provider business mailing address

PO BOX 2947
YAKIMA WA
98907-2947
US

V. Phone/Fax

Practice location:
  • Phone: 509-965-1035
  • Fax: 509-965-1580
Mailing address:
  • Phone: 509-248-7849
  • Fax: 509-249-5042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30006261
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: