Provider Demographics
NPI:1730724303
Name:SLAVEN, KRISTY NICOLE (FNP)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:NICOLE
Last Name:SLAVEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4260 DANIELS ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-4716
Mailing Address - Country:US
Mailing Address - Phone:843-473-5967
Mailing Address - Fax:
Practice Address - Street 1:13911 ST FRANCIS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3256
Practice Address - Country:US
Practice Address - Phone:804-423-9913
Practice Address - Fax:804-423-9929
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily