Provider Demographics
NPI:1043528821
Name:SLAUGHTER, DAWN (NP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 NATCHEZ TRACE AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-7940
Mailing Address - Country:US
Mailing Address - Phone:270-282-2024
Mailing Address - Fax:270-282-2027
Practice Address - Street 1:165 NATCHEZ TRACE AVE
Practice Address - Street 2:STE 205
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-7940
Practice Address - Country:US
Practice Address - Phone:270-282-2024
Practice Address - Fax:270-282-2027
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6637363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner