Provider Demographics
NPI:1366492670
Name:KLUEG-SLATER, RHONDA (NP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:KLUEG-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:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-868-0530
Mailing Address - Fax:812-868-2188
Practice Address - Street 1:1033 E MOUNT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-7149
Practice Address - Country:US
Practice Address - Phone:812-868-0530
Practice Address - Fax:812-868-2188
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000955A363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01186100OtherRAILROAD MEDICARE
000000806247OtherANTHEM
IN146080002Medicare PIN
000000806247OtherANTHEM
000000806247OtherANTHEM