Provider Demographics
NPI:1467239525
Name:SLOAN, JEMMA GUIDRY (RDN)
Entity type:Individual
Prefix:
First Name:JEMMA
Middle Name:GUIDRY
Last Name:SLOAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WALTON PL
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-1713
Mailing Address - Country:US
Mailing Address - Phone:318-218-0065
Mailing Address - Fax:
Practice Address - Street 1:3 WALTON PL
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-1713
Practice Address - Country:US
Practice Address - Phone:318-218-0065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2216133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered