Provider Demographics
NPI:1396942181
Name:SLIM, JENNIFER NADINE (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:NADINE
Last Name:SLIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:NADINE
Other - Last Name:BLEVINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1003 SOUTH 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405
Mailing Address - Country:US
Mailing Address - Phone:253-403-1677
Mailing Address - Fax:253-403-0677
Practice Address - Street 1:1003 SOUTH 5TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-403-1677
Practice Address - Fax:253-403-0677
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7569207R00000X
LADO000384207RH0003X
VA0102202376207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine