Individual
STEPHANIE GRACE SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP
Contact information
Practice address
9411 N LAMAR BLVD STE 120, AUSTIN, TX 78753-4179
(512) 744-6000
(512) 334-1003
Mailing address
9411 N LAMAR BLVD STE 120, AUSTIN, TX 78753-4179
(512) 744-6000
(512) 334-1003
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
644868
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP110325
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3535304-01
—
TX
Enumeration date
11/19/2009
Last updated
04/19/2016
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