Provider Demographics
NPI:1730167685
Name:SLEGHT, MARY P (ARNP)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:P
Last Name:SLEGHT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2962
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33883-2962
Mailing Address - Country:US
Mailing Address - Phone:863-326-9597
Mailing Address - Fax:863-318-0618
Practice Address - Street 1:400 AVENUE K SE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4146
Practice Address - Country:US
Practice Address - Phone:863-294-4404
Practice Address - Fax:863-294-1059
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1526452363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1526452OtherNURSING LICENSE
FL1526452OtherNURSING LICENSE
FLY5981Medicare ID - Type Unspecified