Healthcare Provider Details

I. General information

NPI: 1164712444
Provider Name (Legal Business Name): LAURA LEE SLOANE A.P.R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 BARCLAY ST
SAUGERTIES NY
12477-1904
US

IV. Provider business mailing address

52 RED MILL DR
PALM COAST FL
32164-6614
US

V. Phone/Fax

Practice location:
  • Phone: 845-247-7194
  • Fax:
Mailing address:
  • Phone: 386-225-0798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11011173
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number631394-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: