Individual
TAMMY P. SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
190 KIMEL PARK DR STE 155, WINSTON SALEM, NC 27103-6946
(336) 765-6637
(336) 765-6964
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0050-01740
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003894
—
NC
Enumeration date
06/28/2006
Last updated
06/16/2021
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