Provider Demographics
NPI:1477217438
Name:SLAUGHTER, SANDRA KAYLIE (APRN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:KAYLIE
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3264 N NORTHHILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4005
Mailing Address - Country:US
Mailing Address - Phone:479-521-3300
Mailing Address - Fax:479-521-4914
Practice Address - Street 1:3 E APPLEBY RD STE 401
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3163
Practice Address - Country:US
Practice Address - Phone:479-404-2500
Practice Address - Fax:479-404-2501
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR217878363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health