| Doctor Name: | JESSICA L SLATTERY |
| NPI Number: | 1245518927 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | COA.12439-NP |
| Business Practice Address: | 104 S West Street Edgerton, OH - 43517 |
| Business Phone Number: | 4192982458 |
| Business Fax Number: | |
| Mailing Address: | 208 Columbus St, HICKSVILLE |
| State: | OH |
| Postal Code: | 435261250 |
| Phone Number: | 4195426692 |
| Fax Number: | |
| NPI Enumeration Date: | 07/28/2011 |
| NPI Last Update Date: | 12/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | COA.12439-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |