Kristi M Slack
Nurse Practitioner
3 County Road 4050
Marietta
, Mississippi 38856
Kristi M Slack
Nurse Practitioner
3 County Road 4050
Marietta
, Mississippi 38856
(662) 728-2409
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Kristi M Slack
- Po Box 56
- Marietta, MS
- Zip : 38856-0056
- Fax : (662) 728-2409
- Phone : (662) 728-2408
Second Address
- Kristi M Slack
- 3 County Road 4050
- Marietta, MS
- Zip : 38856
- Fax : (662) 728-2409
- Phone : (662) 728-2408
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Is Kristi M Slack a sole practitioner?
Is Kristi M Slack accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R853095 | MS |
National Provider Identifier
| NPI | 1003840232 |
|---|---|
| Provider Name | Kristi M Slack |
| First Address | Marietta, MS 38856-0056 |
| Second Address | Marietta, MS 38856 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/07/2006 |
| Last Update Date | 11/04/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00239247 | (05) | MS |
| Q21710 | (02) |
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.