Provider Demographics
NPI:1497866297
Name:SLAGLE, CAROLYN FAYE (RN, MSN, CNS)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:FAYE
Last Name:SLAGLE
Suffix:
Gender:F
Credentials:RN, MSN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-4724
Mailing Address - Country:US
Mailing Address - Phone:765-529-6626
Mailing Address - Fax:
Practice Address - Street 1:1401 CHESTER BLVD # A5
Practice Address - Street 2:REID HOSPITAL AND HEALTH CARE SERV
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1908
Practice Address - Country:US
Practice Address - Phone:765-983-3298
Practice Address - Fax:765-983-7970
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2180 RU101YA0400X
IN70000124A364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00197869OtherRAILROAD MEDICARE
OH#2562052OtherOH MEDICAID
P00197869OtherRAILROAD MEDICARE
INP76307Medicare UPIN