MEDICARE: MS. JOAN K. SLAGER C.N.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	4704132728	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134122757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOAN K. SLAGER C.N.M.

Provider Business Mailing Address
First Line	:	3681 S 26TH ST
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-9611
Country	:	US
Telephone Number	:	269-341-7875
Fax Number	:	269-341-6261

Provider Business Practice Location Address
First Line	:	3681 S 26TH ST
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-9611
Country	:	US
Telephone Number	:	269-341-7875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	04/28/2021

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