Provider Demographics
NPI:1477631877
Name:SLEVINSKI, RENE MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:MARIE
Last Name:SLEVINSKI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 ROLAND RD
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-9535
Mailing Address - Country:US
Mailing Address - Phone:850-995-9197
Mailing Address - Fax:
Practice Address - Street 1:4343 LANGLEY AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8511
Practice Address - Country:US
Practice Address - Phone:850-477-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1229692363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9253OtherBLUE CROSS BLUE SHIELD
FLE3867XMedicare ID - Type Unspecified