Provider Demographics
NPI:1164157962
Name:SLONIKER, VICKI CARLENE (PMHNP)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:CARLENE
Last Name:SLONIKER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S ASH ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3224
Mailing Address - Country:US
Mailing Address - Phone:417-667-3355
Mailing Address - Fax:417-448-3659
Practice Address - Street 1:800 S ASH ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-3224
Practice Address - Country:US
Practice Address - Phone:417-667-3355
Practice Address - Fax:417-448-3659
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022027456363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health