Healthcare Provider Details

I. General information

NPI: 1366682924
Provider Name (Legal Business Name): ASHLEY SLOAN CONDO RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 CHAMBLISS AVE NW
CLEVELAND TN
37311-3847
US

IV. Provider business mailing address

1431 CENTERPOINT BLVD SUITE 100
KNOXVILLE TN
37932-1984
US

V. Phone/Fax

Practice location:
  • Phone: 423-559-6000
  • Fax:
Mailing address:
  • Phone: 865-539-8008
  • Fax: 865-560-8960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number150345
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number13917
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: