Provider Demographics
NPI:1346818622
Name:SLATER, LAUREN ELISE (NP)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ELISE
Last Name:SLATER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 KENT DR
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-2335
Mailing Address - Country:US
Mailing Address - Phone:401-439-0374
Mailing Address - Fax:
Practice Address - Street 1:111 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4169
Practice Address - Country:US
Practice Address - Phone:401-439-0374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI02692363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner