MEDICARE: MS. ALICEMARIE F. SLAVEN-EMOND FNP-C

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	363LF0000X	Family Nurse Practitioner	C-APN.0994367-C-NP	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	268890YUZG	OTHER	CO	MEDICARE B FOR DELTA HEALTH & WELLNESS CENTER
4	268890ZS0N	OTHER	CO	MEDICARE B FOR NORTH FORK MEDICAL CLINIC

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
3	R26648	OTHER	NM	NM STATE RN LICENSURE #
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437156254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALICEMARIE F. SLAVEN-EMOND FNP-C

Provider Business Mailing Address
First Line	:	1025 MAIN STREET
Second Line	:
City	:	DELTA
State	:	CO
Zip	:	81416
Country	:	US
Telephone Number	:	970-964-7740
Fax Number	:	970-874-6330

Provider Business Practice Location Address
First Line	:	1025 MAIN STREET
Second Line	:
City	:	DELTA
State	:	CO
Zip	:	81416
Country	:	US
Telephone Number	:	970-964-7740
Fax Number	:	970-874-6330

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	10/01/2024

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Directions to “ MS. ALICEMARIE F. SLAVEN-EMOND FNP-C” Practice Location

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