Provider Demographics
NPI:1609875459
Name:SLIDER, MICHELLE JOY (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:JOY
Last Name:SLIDER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 SOUTHEAST BLVD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-3464
Mailing Address - Country:US
Mailing Address - Phone:330-332-1939
Mailing Address - Fax:330-332-2233
Practice Address - Street 1:2094 E STATE ST
Practice Address - Street 2:SUITE B
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-4409
Practice Address - Country:US
Practice Address - Phone:330-332-1939
Practice Address - Fax:330-332-2233
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-283664363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2352083Medicaid
OH34193177700OtherWORKERS COMP.
OH34193177700OtherWORKERS COMP.