Jacqueline May Slack, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

481548-1 Issued in NY

Practice address

4455 RT 414
Seneca Falls, NY 13148-9531

Phone

(315) 549-7665

NPI assigned

Feb 22, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1396914453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 RT 414",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131489531",
            "telephone_number": "315-549-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 RT 414",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131489531",
            "telephone_number": "315-549-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "JACQUELINE",
        "middle_name": "MAY",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "481548-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seneca Falls School District
• Seneca Ontario Community Service
• William H Sherwood, D.C.
• Eric R Shives, MD
• August Patrick Sinicropi, O.D.
• Sydney Smith
• Soldiers & Sailors Memorial Hospital
• Rhonda L Solomon, PNP C
• Jennifer L Stanton, DC
• David Wemyss Stobie, PA

• Registered Nurse in Seneca Falls, NY
• Providers in Seneca Falls, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.