Provider Demographics
NPI:1972276418
Name:SLAUGHTER, AMBER LEE (APRN-C,FNP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LEE
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:APRN-C,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 PINE BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32348-8580
Mailing Address - Country:US
Mailing Address - Phone:850-843-0183
Mailing Address - Fax:
Practice Address - Street 1:1702 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-5611
Practice Address - Country:US
Practice Address - Phone:855-577-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily