Healthcare Provider Details

I. General information

NPI: 1750897732
Provider Name (Legal Business Name): SLOAN MCCOY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SLOAN COURTNEY FORD

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13950 BRANDYWINE ROAD SUITE 125
BRANDYWINE MD
20613
US

IV. Provider business mailing address

13950 BRANDYWINE RD STE 125
BRANDYWINE MD
20613-5815
US

V. Phone/Fax

Practice location:
  • Phone: 301-782-2220
  • Fax: 301-782-2221
Mailing address:
  • Phone: 301-782-2220
  • Fax: 301-782-2221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR225110
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: