Healthcare Provider Details
I. General information
NPI: 1437371408
Provider Name (Legal Business Name): JANICE D SLOAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/02/2007
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1345 RIVER BEND DR
DALLAS TX
75247-6943
US
IV. Provider business mailing address
1345 RIVER BEND DR
DALLAS TX
75247-6943
US
V. Phone/Fax
- Phone: 214-743-1272
- Fax: 214-630-3625
- Phone: 214-743-1272
- Fax: 214-630-3625
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | 623723 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 03880 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: