Slack, Angelia Dawn

Slack, Angelia Dawn is an individual health care provider with primary practice located at 90 Jackson Pike , Gallipolis OH 45631-1560. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Slack, Angelia Dawn can be contacted via phone (740) 446-5227.

Contact Information

Primary practice address
90 Jackson Pike Gallipolis OH 45631-1560
Phone: (740) 446-5227
Fax: (740) 441-8058
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4064A Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X COA.06914-NA Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 36798 West Virginia

Profile Details

NPI number 1164497178
LBN Legal business name Slack, Angelia Dawn
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated Feb 9th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164497178 NPPES
West Virginia MEDICAID 2605057000
West Virginia MEDICAID 2240702
West Virginia Other 000000223446
West Virginia Other 001714140
West Virginia Other 000000204799
West Virginia Other 430073754

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