Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | CNP161056 | ME |
NPI | 1013360791 |
---|---|
Provider Name | Pamela Slaughter |
First Address | Augusta, ME 04330-8160 |
Second Address | Augusta, ME 04330-8160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2016 |
Last Update Date | 19/07/2016 |