Provider Demographics
NPI:1699366971
Name:SLOAN, JENNIFER SCHMID (LMT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SCHMID
Last Name:SLOAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 CHILHOWEE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-4254
Mailing Address - Country:US
Mailing Address - Phone:865-604-3233
Mailing Address - Fax:
Practice Address - Street 1:322 CHILHOWEE VIEW RD
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-4254
Practice Address - Country:US
Practice Address - Phone:865-604-3233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002558225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN086341956OtherDRIVERS LICENSE