Provider Demographics
NPI:1841715372
Name:SLAYTON, KENYA (RN, BSN)
Entity type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:SLAYTON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3119 CASSINIA PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HEARTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75126-0767
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3119 CASSINIA PKWY
Practice Address - Street 2:
Practice Address - City:HEARTLAND
Practice Address - State:TX
Practice Address - Zip Code:75126-0767
Practice Address - Country:US
Practice Address - Phone:706-267-0047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-05
Last Update Date:2017-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX842531163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse