Provider Demographics
NPI:1093588287
Name:SLONE, WILMA LOUISE (RN)
Entity Type:Individual
Prefix:
First Name:WILMA
Middle Name:LOUISE
Last Name:SLONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:WILMA
Other - Middle Name:
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:240 GARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-9570
Mailing Address - Country:US
Mailing Address - Phone:606-276-0686
Mailing Address - Fax:
Practice Address - Street 1:202 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-833-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1089115163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health