Basic Information
Provider Information
NPI: 1588253686
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SLAVIK
FirstName: NATALIE
MiddleName: KANIS
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2830 VICTORY PKWY
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452061785
CountryCode: US
TelephoneNumber: 5132453072
FaxNumber: 5135855511
Practice Location
Address1: 234 GOODMAN ST
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452192364
CountryCode: US
TelephoneNumber: 5134758521
FaxNumber: 5134757480
Other Information
ProviderEnumerationDate: 01/13/2021
LastUpdateDate: 01/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XOH.432353OHN Nursing Service ProvidersRegistered Nurse 
363LA2100XAPRN.CNP.0027760OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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