Provider Demographics
NPI:1477857084
Name:SLATTON, LACEY NICHOLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:NICHOLE
Last Name:SLATTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 CRISP SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-5245
Mailing Address - Country:US
Mailing Address - Phone:931-743-9188
Mailing Address - Fax:
Practice Address - Street 1:306 N CHANCERY ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2048
Practice Address - Country:US
Practice Address - Phone:931-474-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-23
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000035742363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily