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General NPI Number Information
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NPI Number | 1457898876
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Entity Type | Individual
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Provider Name | CHRISTINE RUTHANNE SLACK NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/23/2017
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 2316 E MEYER BLVD 1 EAST
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City | KANSAS CITY
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State | MO
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Zip | 64132-1199
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Country | US
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Telephone | 816-974-5050
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Fax | 816-683-7645
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Provider Business Mailing Address
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Address Line | PO BOX 749495
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City | ATLANTA
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State | GA
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Zip | 30374-9495
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Country | US
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Telephone | 855-963-2100
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Fax | 813-321-1296
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2023037602
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2023037602
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License Number State | MO
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