Provider Demographics
NPI:1245913383
Name:SLAUGHTER, LAURA DAWN (RN, FNP-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:DAWN
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2795 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:SN LUIS OBISP
Mailing Address - State:CA
Mailing Address - Zip Code:93401-5347
Mailing Address - Country:US
Mailing Address - Phone:805-459-0154
Mailing Address - Fax:
Practice Address - Street 1:1428 PHILLIPS LN STE 203
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2551
Practice Address - Country:US
Practice Address - Phone:805-439-1797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily