Healthcare Provider Details

I. General information

NPI: 1114843208
Provider Name (Legal Business Name): GRACE SLOAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W 86TH ST
INDIANAPOLIS IN
46260-1902
US

IV. Provider business mailing address

3963 S 565 W
NEW PALESTINE IN
46163-8758
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-2345
  • Fax:
Mailing address:
  • Phone: 317-771-1198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: