Healthcare Provider Details

I. General information

NPI: 1053878231
Provider Name (Legal Business Name): CYNTHIA SLOANE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 NEWTON ST
SAINT JOSEPH LA
71366-4330
US

IV. Provider business mailing address

PO BOX 6
SAINT JOSEPH LA
71366-0006
US

V. Phone/Fax

Practice location:
  • Phone: 318-766-8506
  • Fax: 318-766-8571
Mailing address:
  • Phone: 318-766-8506
  • Fax: 318-766-8571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number38568
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: