Individual
MISS ASHLEY BLAIRE SLATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2604 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9417
(919) 580-0004
(919) 580-9224
Mailing address
2604 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9417
(919) 580-0004
(919) 580-9224
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
001001606
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001001606
NC MEDIAL LICENSE
NC
Enumeration date
11/19/2008
Last updated
06/05/2024
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