Individual
MICHELLE SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
560 TAVERN HILL RD, JONESBOROUGH, TN 37659-4630
(423) 676-1522
Mailing address
560 TAVERN HILL RD, JONESBOROUGH, TN 37659-4630
(423) 676-1522
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
95673
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95673
PRACTICAL NURSE LICENSE
TN
Enumeration date
10/13/2021
Last updated
10/13/2021
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