Provider Demographics
NPI:1326089236
Name:SLOAN, REBECCA S (ANP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:S
Last Name:SLOAN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:7366 TAPPAN DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-5708
Mailing Address - Country:US
Mailing Address - Phone:317-328-2669
Mailing Address - Fax:317-326-2669
Practice Address - Street 1:2862 W 100 N
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-7856
Practice Address - Country:US
Practice Address - Phone:317-326-1221
Practice Address - Fax:317-326-1805
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71000665A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP19305Medicare UPIN