Provider Demographics
NPI:1922087683
Name:SLATER, MARILYN E (NPF)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:E
Last Name:SLATER
Suffix:
Gender:F
Credentials:NPF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 COHASSET RD
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2213
Mailing Address - Country:US
Mailing Address - Phone:530-342-4395
Mailing Address - Fax:530-894-2325
Practice Address - Street 1:680 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2213
Practice Address - Country:US
Practice Address - Phone:530-342-4395
Practice Address - Fax:530-894-2325
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP13302363LF0000X
CA505668163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA505668OtherRN
CA53308OtherPHN
Q37227Medicare UPIN