Provider Demographics
NPI:1629766902
Name:SLAUGHTER, JASMINE L
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:L
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5636 OLD HICKORY BLVD APT 411
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3298
Mailing Address - Country:US
Mailing Address - Phone:615-650-3826
Mailing Address - Fax:
Practice Address - Street 1:5636 OLD HICKORY BLVD APT 411
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3298
Practice Address - Country:US
Practice Address - Phone:615-650-3826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN240059251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health