Provider Demographics
NPI:1467729277
Name:SLOAN, KANDISE SHAREE (PA)
Entity Type:Individual
Prefix:MS
First Name:KANDISE
Middle Name:SHAREE
Last Name:SLOAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PERIMETER PARK RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2200
Mailing Address - Country:US
Mailing Address - Phone:865-247-6340
Mailing Address - Fax:
Practice Address - Street 1:110 PERIMETER PARK RD
Practice Address - Street 2:SUITE G
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2200
Practice Address - Country:US
Practice Address - Phone:865-247-6340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program