Individual
PAULA B SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4260 PLYMOUTH RD, ANN ARBOR, MI 48109-2700
(734) 764-6831
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704196109
MI
363LP2300X
Primary Care Nurse Practitioner
COA11004
OH
Other
Enumeration date
10/13/2009
Last updated
10/25/2022
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