Healthcare Provider Details

I. General information

NPI: 1144202169
Provider Name (Legal Business Name): SLOAN SHEFFIELD CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SLOAN S CORNISH CRNA

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 S WOODS MILL RD
CHESTERFIELD MO
63017-3406
US

IV. Provider business mailing address

232 S WOODS MILL RD
CHESTERFIELD MO
63017-3406
US

V. Phone/Fax

Practice location:
  • Phone: 314-205-6917
  • Fax:
Mailing address:
  • Phone: 314-205-6917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN142815
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041-330661
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number142815
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209004573
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: