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Individual

MS. JUANITA GALE SLAIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
110916 S 4756 RD, MULDROW, OK 74948-5313
(479) 739-0106
Mailing address
110916 S 4756 RD, MULDROW, OK 74948-5313
(479) 739-0106

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R22646
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R22646
REGISTERED NURSE LICENSE
AR
Enumeration date
07/22/2010
Last updated
07/22/2010
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