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NPI Code Detail

MEDICARE: VENESSA MONIQUE SLATER RN, IBCLC

MEDICARE:   VENESSA MONIQUE SLATER  RN, IBCLC
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
1163WL0100XLactation Consultant (Registered Nurse)915498TX

General Provider Information

NPI Number : 1275392599
Entity Type Code : Individual
Provider Name (Legal Business Name) : VENESSA MONIQUE SLATER RN, IBCLC
Provider Business Mailing Address
First Line : 5330 CASTLECREEK LN
Second Line :
City : HOUSTON
State : TX
Zip : 77053-3643
Country : US
Telephone Number : 713-449-6298
Fax Number :
Provider Business Practice Location Address
First Line : 5330 CASTLECREEK LN
Second Line :
City : HOUSTON
State : TX
Zip : 77053-3643
Country : US
Telephone Number : 713-449-6298
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2024
Last Update Date : 03/18/2024

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Directions to “ VENESSA MONIQUE SLATER RN, IBCLC” Practice Location

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