Individual
KALLEN BLANKENBURG SLAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
29 TIGER TRL, RINGGOLD, GA 30736-2024
(706) 935-2254
Mailing address
13570 N MAIN ST, TRENTON, GA 30752-2012
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
216119
TN
363LF0000X
Family Nurse Practitioner
Primary
GAA-NP000859
GA
Other
Enumeration date
06/07/2022
Last updated
07/24/2023
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