Healthcare Provider Details

I. General information

NPI: 1467387506
Provider Name (Legal Business Name): CHARLES IAN SLOAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988102 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8102
US

IV. Provider business mailing address

505 W CENTENNIAL RD
PAPILLION NE
68046-4304
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-6779
  • Fax:
Mailing address:
  • Phone: 402-515-9039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number116974
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: