Provider Demographics
NPI:1740756675
Name:SLATON, VERNIE
Entity Type:Individual
Prefix:
First Name:VERNIE
Middle Name:
Last Name:SLATON
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 1:2899 COUNTY ROAD 739
Mailing Address - Street 2:
Mailing Address - City:HENAGAR
Mailing Address - State:AL
Mailing Address - Zip Code:35978-3849
Mailing Address - Country:US
Mailing Address - Phone:256-605-4836
Mailing Address - Fax:
Practice Address - Street 1:617 GAULT AVE N
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-2531
Practice Address - Country:US
Practice Address - Phone:256-979-1633
Practice Address - Fax:256-304-5456
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24980363LF0000X
AL1-090087363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily