| NPI | 1982147641 |
|---|---|
| Former Name | NICOLE D SLACK-SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60721271) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60202435) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2021-04-01 |