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General NPI Number Information
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NPI Number | 1013811298
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Entity Type | Individual
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Provider Name | TANIKKA MARIE SLOWE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 101 W TOWNSEND RD
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City | SAINT JOHNS
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State | MI
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Zip | 48879-9200
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Country | US
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Telephone | 989-403-6022
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Fax |
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Provider Business Mailing Address
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Address Line | 125 W CESAR E CHAVEZ AVE APT 2
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City | LANSING
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State | MI
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Zip | 48906-4860
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Country | US
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Telephone | 989-403-6022
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704411544
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License Number State | MI
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