Provider Demographics
NPI:1497183438
Name:SLOCUM, TINA MARIE (CNM)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:SLOCUM
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Gender:F
Credentials:CNM
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Mailing Address - Street 1:161 RIVERSIDE DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4176
Mailing Address - Country:US
Mailing Address - Phone:607-770-7074
Mailing Address - Fax:607-770-3452
Practice Address - Street 1:161 RIVERSIDE DR
Practice Address - Street 2:SUITE 109
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4176
Practice Address - Country:US
Practice Address - Phone:607-770-7074
Practice Address - Fax:607-770-3452
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2016-06-14
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Provider Licenses
StateLicense IDTaxonomies
NY001681367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife