Individual
SUSAN B SLATTERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, WHNP
Contact information
Practice address
99 CENTRAL AVE, ASHLAND, OR 97520-1787
(541) 482-9741
(541) 488-6141
Mailing address
19 MYRTLE ST, MEDFORD, OR 97504-7337
(541) 482-9741
(541) 488-6141
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14663
WI
363LP2300X
Primary Care Nurse Practitioner
200850169NP
OR
363LW0102X
Women's Health Nurse Practitioner
200850169NP
OR
367A00000X
Advanced Practice Midwife
200850169NP
OR
367A00000X
Advanced Practice Midwife
209-001582
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-305999
RN LICENSE
IL
01
—
200850169NP
OREGON LICENSE
OR
01
—
209-001582
APN LICENSE
IL
Enumeration date
05/31/2006
Last updated
11/10/2021
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