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General NPI Number Information
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NPI Number | 1063164143
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Entity Type | Individual
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Provider Name | SARAH L SLAVIK NP
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Gender | Female
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 4100 CAMPUS RIDGE DR
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City | MIDLAND
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State | MI
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Zip | 48640-6139
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Country | US
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Telephone | 989-839-1386
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Fax | 989-839-3324
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Provider Business Mailing Address
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Address Line | 2056 W PINE RIVER RD
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City | BRECKENRIDGE
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State | MI
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Zip | 48615-9615
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Country | US
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Telephone | 989-388-8101
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704269796
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704269796
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License Number State | MI
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