Provider Demographics
NPI:1144420829
Name:SLAYDEN, CARLA R (FNP)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:R
Last Name:SLAYDEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2922 COVINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-6007
Mailing Address - Country:US
Mailing Address - Phone:901-722-0088
Mailing Address - Fax:901-722-0082
Practice Address - Street 1:1325 EASTMORELAND AVE
Practice Address - Street 2:SUITE 525
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3519
Practice Address - Country:US
Practice Address - Phone:901-722-0088
Practice Address - Fax:901-722-0082
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily