Provider Demographics
NPI:1801869797
Name:SLICE, ALLISON (FNP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SLICE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-346-3900
Mailing Address - Fax:843-346-7839
Practice Address - Street 1:755 E SMITH ST
Practice Address - Street 2:
Practice Address - City:TIMMONSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29161-9430
Practice Address - Country:US
Practice Address - Phone:843-346-3900
Practice Address - Fax:843-346-7839
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 1550363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0583Medicaid
SC250470363OtherBLUE CROSS ID NO.
SC250470363OtherWRK. COMP. ID NO.
SC250470363OtherWRK. COMP. ID NO.
SC250470363OtherBLUE CROSS ID NO.