Individual
JODIA M. SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9550 ROCKY RIVER RD STE 150, CHARLOTTE, NC 28215-9592
(704) 457-1510
(704) 457-1506
Mailing address
PO BOX 601843, CHARLOTTE, NC 28260-1843
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5002900
NC
363LF0000X
Family Nurse Practitioner
0050-02900
NC
363LF0000X
Family Nurse Practitioner
214803
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609905983
—
NC
05
—
NP1101
—
SC
Enumeration date
03/05/2007
Last updated
08/09/2021
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