Provider Demographics
NPI:1043779846
Name:SLAUGHTER, YOLANDA KENYOTTA
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:KENYOTTA
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6641 FAIRPARK AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45216-1923
Mailing Address - Country:US
Mailing Address - Phone:513-328-8200
Mailing Address - Fax:
Practice Address - Street 1:4201 VICTORY PKWY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-1645
Practice Address - Country:US
Practice Address - Phone:513-914-5458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN112457164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse