Slaughter, Connie Marie

Slaughter, Connie Marie is an individual health care provider with primary practice located at 1005 Mar Walt Drive Immediate Care Department, Fort Walton Beach FL 32547-6707. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Slaughter, Connie Marie can be contacted via phone (850) 863-8219.

Contact Information

Primary practice address
1005 Mar Walt Drive Immediate Care Department Fort Walton Beach FL 32547-6707
Phone: (850) 863-8219
Fax: (850) 863-8249
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9459708 Florida

Profile Details

NPI number 1104141928
LBN Legal business name Slaughter, Connie Marie
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2010
Last updated Oct 19th, 2018 - about 6 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 1104141928 NPPES
Florida Other YNZR7 BCBSFL
Florida MEDICAID 020978600 BCBSFL

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