Jennifer Johnson Slade
Nurse Practitioner - Pediatrics
3888 Northside Dr
Macon
, Georgia 31210-2417
Jennifer Johnson Slade
Nurse Practitioner - Pediatrics
3888 Northside Dr
Macon
, Georgia 31210-2417
(478) 477-7076
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Jennifer Johnson Slade
- 3888 Northside Dr
- Macon, GA
- Zip : 31210-2417
- Fax : (478) 477-7076
- Phone : (478) 477-4044
Second Address
- Jennifer Johnson Slade
- 3888 Northside Dr
- Macon, GA
- Zip : 31210-2417
- Fax : (478) 477-7076
- Phone : (478) 477-4044
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN117428 NP | GA |
National Provider Identifier
| NPI | 1013147503 |
|---|---|
| Provider Name | Jennifer Johnson Slade |
| First Address | Macon, GA 31210-2417 |
| Second Address | Macon, GA 31210-2417 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/07/2009 |
| Last Update Date | 20/07/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.