Provider Demographics
NPI:1831363399
Name:SLOAN, JESSICA MARIE (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:SLOAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2778
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-2778
Mailing Address - Country:US
Mailing Address - Phone:910-893-2641
Mailing Address - Fax:910-893-3208
Practice Address - Street 1:56 N BROAD ST E
Practice Address - Street 2:
Practice Address - City:ANGIER
Practice Address - State:NC
Practice Address - Zip Code:27501-8964
Practice Address - Country:US
Practice Address - Phone:910-893-2641
Practice Address - Fax:910-893-3208
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-01008207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine