Provider Demographics
NPI:1952361156
Name:SLIDELL, CAROLINE ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:ANN
Last Name:SLIDELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 E HURON ST FL 11
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-694-8536
Mailing Address - Fax:312-926-5891
Practice Address - Street 1:251 E HURON ST FL 11
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-694-8536
Practice Address - Fax:312-926-5891
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209010256363L00000X
DCRN962035363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care