Provider Demographics
NPI:1568596021
Name:SLAYTON, TAMI (RN, LAC)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:
Last Name:SLAYTON
Suffix:
Gender:F
Credentials:RN, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SOUTH SIDE SQUARE
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37144
Mailing Address - Country:US
Mailing Address - Phone:615-300-3501
Mailing Address - Fax:
Practice Address - Street 1:212 SOUTH SIDE SQUARE
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:TN
Practice Address - Zip Code:37144
Practice Address - Country:US
Practice Address - Phone:615-300-3501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist