Provider Demographics
NPI:1588950794
Name:SLOANE, SHELLEY M (LPN)
Entity type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:M
Last Name:SLOANE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8073 ALLOWAY RD
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:NY
Mailing Address - Zip Code:14489-9714
Mailing Address - Country:US
Mailing Address - Phone:315-359-3959
Mailing Address - Fax:
Practice Address - Street 1:8073 ALLOWAY RD
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:NY
Practice Address - Zip Code:14489-9714
Practice Address - Country:US
Practice Address - Phone:315-359-3959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-26
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299554-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse