Provider Demographics
NPI:1366858755
Name:SLOAN, KOURTNEY BROWN (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KOURTNEY
Middle Name:BROWN
Last Name:SLOAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:KOURTNEY
Other - Middle Name:MICHELLE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:3510 JOHN PLATT DR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4321
Mailing Address - Country:US
Mailing Address - Phone:252-726-0511
Mailing Address - Fax:252-726-7441
Practice Address - Street 1:3510 JOHN PLATT DR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4321
Practice Address - Country:US
Practice Address - Phone:252-726-0511
Practice Address - Fax:252-726-7441
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC234831363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC188HROtherBCBS