Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 61941811205 | UT |
N | 207VE0102X | Reproductive Endocrinologist | G81581 | CA |
Y | 207VE0102X | Reproductive Endocrinologist | M8614 | ID |
NPI | 1013014745 |
---|---|
Provider Name | Cristin C Slater |
First Address | Boise, ID 83702-7307 |
Second Address | Boise, ID 83702-7307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51292 | BLUE CROSS (01) | ID |
H66874 | (02) |