Healthcare Provider Details

I. General information

NPI: 1427393859
Provider Name (Legal Business Name): JOY DELL SLOAN RN, BSN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2012
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2622 W CENTRAL AVE SUITE 500
WICHITA KS
67203-4969
US

IV. Provider business mailing address

2622 W CENTRAL AVE SUITE 500
WICHITA KS
67203-4969
US

V. Phone/Fax

Practice location:
  • Phone: 316-660-5120
  • Fax: 316-383-7757
Mailing address:
  • Phone: 316-660-5120
  • Fax: 316-383-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number1481020112
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: