Provider Demographics
NPI:1003901158
Name:SLATER, JOYCE MARIE (CNM, MSN)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:MARIE
Last Name:SLATER
Suffix:
Gender:F
Credentials:CNM, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:SHARON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:13459-0304
Mailing Address - Country:US
Mailing Address - Phone:765-425-6592
Mailing Address - Fax:765-425-6592
Practice Address - Street 1:920 LARK DR
Practice Address - Street 2:WHITNEY YOUNG HEALTH CENTER, INC
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-1300
Practice Address - Country:US
Practice Address - Phone:518-465-4771
Practice Address - Fax:518-462-1287
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001448-1367A00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200092620Medicaid