Individual
JENNIFER AUSTIN SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
4032 N MILLER RD, SUITE 108, SCOTTSDALE, AZ 85251-4572
(480) 360-2299
Mailing address
14780 W MOUNTAIN VIEW BLVD, STE 110, SURPRISE, AZ 85374-7280
(623) 322-6923
(855) 420-6361
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN001303
NV
405300000X
Prevention Professional
AP3104
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649426826
—
NV
Enumeration date
08/07/2008
Last updated
01/19/2017
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