Provider Demographics
NPI:1023737269
Name:SLATER, SARAH (DNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SLATER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15672 FREMONT AVE NW
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-1638
Mailing Address - Country:US
Mailing Address - Phone:661-205-2465
Mailing Address - Fax:
Practice Address - Street 1:15672 FREMONT AVE NW
Practice Address - Street 2:
Practice Address - City:PRIOR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55372-1638
Practice Address - Country:US
Practice Address - Phone:661-205-2465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR234740-2163WP0200X
MN9600363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics