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NPI Code Detail

MEDICARE: MS. AMANDA W SLATER F.N.P.

MEDICARE: MS. AMANDA W SLATER F.N.P.
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
1363LF0000XFamily Nurse Practitioner1909SC

Other Identifiers

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

General Provider Information

NPI Number : 1316900855
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMANDA W SLATER F.N.P.
Provider Business Mailing Address
First Line : 1330 DUTCH FORK RD
Second Line :
City : IRMO
State : SC
Zip : 29063-8825
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1330 DUTCH FORK RD
Second Line :
City : IRMO
State : SC
Zip : 29063-8825
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2006
Last Update Date : 12/09/2025

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