Provider Demographics
NPI:1831532167
Name:SLOAN, JENNA KENNEDY (MD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:KENNEDY
Last Name:SLOAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:LYNN
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2214 CANTERBURY DR STE 210
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2375
Mailing Address - Country:US
Mailing Address - Phone:785-623-5806
Mailing Address - Fax:785-623-2343
Practice Address - Street 1:2214 CANTERBURY DR STE 210
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2375
Practice Address - Country:US
Practice Address - Phone:785-623-5806
Practice Address - Fax:785-623-2343
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10047221207V00000X
KS0439742207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology