Provider Demographics
NPI:1467616797
Name:SLOAN, CARLA RAINA (RPA,RT(R)(M))
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:RAINA
Last Name:SLOAN
Suffix:
Gender:F
Credentials:RPA,RT(R)(M)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 YANCEYVILLE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-6963
Mailing Address - Country:US
Mailing Address - Phone:336-895-1598
Mailing Address - Fax:336-390-2170
Practice Address - Street 1:1414 YANCEYVILLE ST STE 200
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6963
Practice Address - Country:US
Practice Address - Phone:336-895-1598
Practice Address - Fax:336-390-2170
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC247100000X
NC04NC1094243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist