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Individual

LORRAINE N SLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2550 S PARKER RD, AURORA, CO 80014-1622
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-4545

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
110641
CO
363L00000X
Nurse Practitioner
Primary
1854
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
015330
KAISER-COMMERCIAL NUMBER
05
32509863
CO
Enumeration date
02/27/2007
Last updated
04/09/2018
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