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KIMBERLY A SLATTERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
5734 COVENTRY LN, FORT WAYNE, IN 46804-7141
(260) 436-7875
(260) 432-9812
Mailing address
442 W HIGH ST, BRYAN, OH 43506-1681
(419) 636-4517
(419) 636-6438

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
275603
AZ
367500000X
Certified Registered Nurse Anesthetist
4704242032
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00477902
MEDICARE RAILROAD
OH
Enumeration date
11/14/2007
Last updated
06/29/2022
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