Doctor Name: | MRS. CHRISTINE MARIE SLACK |
NPI Number: | 1659407617 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN |
License Number: | LP040169 |
Business Practice Address: | 3701 E Broadway Ave Apache Junction, AZ - 852199301 |
Business Phone Number: | 4809821110 |
Business Fax Number: | 4802880532 |
Mailing Address: | 10470 E Dutchmans Trl, GOLD CANYON |
State: | AZ |
Postal Code: | 852184916 |
Phone Number: | 4809832311 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | LP040169 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |