Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miranda E Slack

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1508494220

Miranda E Slack is a Student in an Organized Health Care Education/Training Program in Tuscaloosa, Alabama. Practices as a sole proprietor. Licensed in Alabama.

Licensed in
AL
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

525 Frank Thomas Ave Apt 5
Tuscaloosa, AL 35401-2265
Phone: (801) 326-9911
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X (AL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (AL)

Record details

NPI number1508494220
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 29, 2020
Last updated in NPPESMarch 29, 2020
Certification dateMarch 29, 2020

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