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PATRICIA E SLOTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-1774
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
(616) 486-6772
(616) 486-6702

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
4704170121
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4704170121
STATE LICENSE
MI
Enumeration date
12/14/2006
Last updated
10/06/2009
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