Individual
DIANE BERRY SLOUGH
Active
Individual
DIANE BERRY SLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
118370
MO
363LF0000X
Family Nurse Practitioner
Primary
2014035654
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118370
RN LICENSE
MO
01
—
2014035654
FAMILY NURSE PRACTITIONER
MO
Enumeration date
09/30/2014
Last updated
02/23/2016
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