Provider Demographics
NPI:1134703689
Name:SLAUGHTER, JAQUIARA SHAUNTRIESE (NP)
Entity type:Individual
Prefix:MRS
First Name:JAQUIARA
Middle Name:SHAUNTRIESE
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1800 HOWELL MILL RD NW STE 450
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2508
Mailing Address - Country:US
Mailing Address - Phone:404-355-4393
Mailing Address - Fax:404-609-7665
Practice Address - Street 1:1800 HOWELL MILL RD NW STE 450
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2508
Practice Address - Country:US
Practice Address - Phone:404-355-4393
Practice Address - Fax:404-609-7665
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN269693363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care