Individual
MRS. JENNIFER KAY SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
917 REMINGTON RD, MATTOON, IL 61938-4210
(217) 205-3376
(217) 481-7020
Mailing address
917 REMINGTON RD, MATTOON, IL 61938-4210
(217) 205-3376
(217) 481-7020
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2281
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U7355A
MEDICARE PTAN
—
Enumeration date
05/17/2006
Last updated
08/24/2022
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