Provider Demographics
NPI:1972181329
Name:SLIGHTOM, SARAH JOHNSON
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JOHNSON
Last Name:SLIGHTOM
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 1:5502 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2536
Mailing Address - Country:US
Mailing Address - Phone:704-902-6785
Mailing Address - Fax:
Practice Address - Street 1:5502 PELHAM RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2536
Practice Address - Country:US
Practice Address - Phone:704-902-6785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program