Provider Demographics
NPI:1336899574
Name:SLAUGHTER, ANGELA KAY
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAY
Last Name:SLAUGHTER
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 1:1665 ANTILLEY RD SUITE 170
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-9681
Mailing Address - Country:US
Mailing Address - Phone:325-793-5148
Mailing Address - Fax:
Practice Address - Street 1:1665 ANTILLEY RD STE 170
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5264
Practice Address - Country:US
Practice Address - Phone:325-793-5148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX923511163W00000X
TX1087015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse