Provider Demographics
NPI:1508154824
Name:SLOTWINSKI, MAX L (DNP FPMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MAX
Middle Name:L
Last Name:SLOTWINSKI
Suffix:
Gender:X
Credentials:DNP FPMHNP-BC
Other - Prefix:DR
Other - First Name:KATE
Other - Middle Name:L
Other - Last Name:SLOTWINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP FPMHNP-BC
Mailing Address - Street 1:277 MISSION TRIPP ST
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-7824
Mailing Address - Country:US
Mailing Address - Phone:845-641-9524
Mailing Address - Fax:845-215-0447
Practice Address - Street 1:271 S BROADWAY
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-4636
Practice Address - Country:US
Practice Address - Phone:845-641-9524
Practice Address - Fax:845-215-0447
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401405363LP0808X
NC5006913363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health