SUZANNA LOUISE SLATER (AGNP, MSN, RN) – Nurse Practitioner, NPI 1609673961

SUZANNA LOUISE SLATER (AGNP, MSN, RN) is a healthcare provider. based in Salt lake city, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials AGNP, MSN, RN. They hold a License No. 14187712-4405 (UT). The NPI Number for SUZANNA LOUISE SLATER (AGNP, MSN, RN) is 1609673961

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
SUZANNA LOUISE SLATER (AGNP, MSN, RN)
NPI
1609673961
Phone
(203) 640-4429
Address
456 E VICTORIA PL
Enumeration Date
25 February 2025
Last Update Date
25 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8017565293
Graduation Year
2021 (5 years ago)
PAC ID
7315450475
Group Practice PAC ID
2163931106
Professional Enrollment ID
I20250701003671
Address ID
UT840031717AM350XX300X300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

2,657 NURSE PRACTITIONER in UT

Provider Addresses for SUZANNA LOUISE SLATER (AGNP, MSN, RN)

  • 456 E VICTORIA PL

    SALT LAKE CITY, UT 841033157

    Phone: (203) 640-4429

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250701003671INurse PractitionerUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84103)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163931106View full group profile
NameSpecialtyState
Physician AssistantUT
Nurse PractitionerOH
Physical Medicine And RehabilitationUT
Nurse PractitionerUT

Reviews

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Frequently asked questions

What identifier follows SUZANNA LOUISE SLATER (AGNP, MSN, RN) across health systems?
The NPI 1609673961 uniquely identifies SUZANNA LOUISE SLATER (AGNP, MSN, RN) in U.S. healthcare data.
Does the public listing show SUZANNA LOUISE SLATER (AGNP, MSN, RN) as active?
SUZANNA LOUISE SLATER (AGNP, MSN, RN)'s NPI record reflects an active status in NPPES.
What type of care does SUZANNA LOUISE SLATER (AGNP, MSN, RN) provide?
SUZANNA LOUISE SLATER (AGNP, MSN, RN)'s profile centers on Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Can patients visit SUZANNA LOUISE SLATER (AGNP, MSN, RN) in Salt Lake City, Utah?
For routing, start with Salt Lake City, Utah for SUZANNA LOUISE SLATER (AGNP, MSN, RN), then verify phone and hours locally.
Can I export SUZANNA LOUISE SLATER (AGNP, MSN, RN)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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