Provider Demographics
NPI:1457311714
Name:SLOAN, JESSICA M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:M
Last Name:SLOAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:M
Other - Last Name:DAIGNEAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:295 N KERRWOOD DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-5207
Mailing Address - Country:US
Mailing Address - Phone:724-346-6425
Mailing Address - Fax:724-346-6474
Practice Address - Street 1:295 N KERRWOOD DR
Practice Address - Street 2:SUITE 104
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-5207
Practice Address - Country:US
Practice Address - Phone:724-346-6425
Practice Address - Fax:724-346-6474
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051655363AM0700X
PAOA003188363A00000X
OH003796363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1811043OtherHIGHMARK BLUE CROSS B.S.
PA1811043OtherHIGHMARK BLUE CROSS B.S.