Provider Demographics
NPI:1679025795
Name:SLOAN, CLAUDIA IRENE (IDMT)
Entity Type:Individual
Prefix:
First Name:CLAUDIA IRENE
Middle Name:
Last Name:SLOAN
Suffix:
Gender:F
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W ENT AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1595
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21ST MDG 559 VINCENT STREET
Practice Address - Street 2:
Practice Address - City:PAFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1595
Practice Address - Country:US
Practice Address - Phone:719-556-5898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians