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General NPI Number Information
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NPI Number | 1659572949
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Entity Type | Individual
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Provider Name | ARMANDO WAYNE SLACK APRN
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Gender | Male
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 3780 S WEST TEMPLE STE 201
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City | SOUTH SALT LAKE
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State | UT
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Zip | 84115-4464
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Country | US
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Telephone | 385-444-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 2193 RIFLEMAN DR
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City | FARMINGTON
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State | UT
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Zip | 84025-2792
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Country | US
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Telephone | 801-557-4257
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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 | 2943544405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 2943543102
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License Number State | UT
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