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General NPI Number Information
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NPI Number | 1346834090
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Entity Type | Individual
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Provider Name | ANDREA C SLATER
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Gender | Female
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 509 MICHIGAN AVE
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City | NITRO
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State | WV
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Zip | 25143-2456
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Country | US
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Telephone | 304-747-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 509 MICHIGAN AVE
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City | NITRO
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State | WV
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Zip | 25143-2456
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Country | US
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Telephone |
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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