Individual
ETHAN THOMAS SLABAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
82 WENDELL AVE STE 100, PITTSFIELD, MA 01201-7066
(617) 517-6340
(423) 301-6604
Mailing address
82 WENDELL AVE STE 100, PITTSFIELD, MA 01201-7066
(617) 517-6340
(423) 301-6604
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2361626
MA
363LF0000X
Family Nurse Practitioner
RN2361626
MA
Other
Enumeration date
08/30/2022
Last updated
02/19/2025
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