Provider Demographics
NPI:1093024051
Name:SLAUGHTER, KANSHIE LEMAR
Entity Type:Individual
Prefix:
First Name:KANSHIE
Middle Name:LEMAR
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 1:1129 WELLSPRING DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3650
Mailing Address - Country:US
Mailing Address - Phone:513-598-0300
Mailing Address - Fax:
Practice Address - Street 1:1129 WELLSPRING DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3650
Practice Address - Country:US
Practice Address - Phone:513-598-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN137165MIV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse