Provider Demographics
NPI:1659035822
Name:SLATER, MEGAN ELIZBETH (FNP-C)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZBETH
Last Name:SLATER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:PLASKOV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:407 E MAPLE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2616
Mailing Address - Country:US
Mailing Address - Phone:770-888-6697
Mailing Address - Fax:866-892-0151
Practice Address - Street 1:407 E MAPLE ST STE 101
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2616
Practice Address - Country:US
Practice Address - Phone:770-888-6697
Practice Address - Fax:866-892-0151
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN255831363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner