Provider Demographics
NPI:1679327969
Name:SLOANE, ELISE MARY (RN)
Entity Type:Individual
Prefix:MS
First Name:ELISE
Middle Name:MARY
Last Name:SLOANE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28073 BLUE SKY DR
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-4278
Mailing Address - Country:US
Mailing Address - Phone:504-915-3723
Mailing Address - Fax:
Practice Address - Street 1:28073 BLUE SKY DR
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-4278
Practice Address - Country:US
Practice Address - Phone:504-915-3723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN126693163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse