Provider Demographics
NPI:1457044257
Name:SLADE, KIERA RU'SHELLE (FNP-BC, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:KIERA
Middle Name:RU'SHELLE
Last Name:SLADE
Suffix:
Gender:
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E SIX FORKS RD UNIT 522
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1843
Mailing Address - Country:US
Mailing Address - Phone:336-514-3587
Mailing Address - Fax:
Practice Address - Street 1:8838 US 70 HWY BUSINESS W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520
Practice Address - Country:US
Practice Address - Phone:919-870-8409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF05231126363LF0000X
NC5018168363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily