Provider Demographics
NPI:1255854022
Name:SLATON, SARA MARICLE (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MARICLE
Last Name:SLATON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:BERNICE
Mailing Address - State:LA
Mailing Address - Zip Code:71222-0697
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:409 1ST ST
Practice Address - Street 2:
Practice Address - City:BERNICE
Practice Address - State:LA
Practice Address - Zip Code:71222-4001
Practice Address - Country:US
Practice Address - Phone:318-285-9066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09307363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily