Provider Demographics
NPI:1841247442
Name:SLOAN, ALETA LYNN (PA)
Entity type:Individual
Prefix:
First Name:ALETA
Middle Name:LYNN
Last Name:SLOAN
Suffix:
Gender:F
Credentials:PA
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 12248
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561-2248
Mailing Address - Country:US
Mailing Address - Phone:252-514-6685
Mailing Address - Fax:252-514-2745
Practice Address - Street 1:941 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5252
Practice Address - Country:US
Practice Address - Phone:252-634-3278
Practice Address - Fax:252-633-3312
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101395363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1841247442Medicaid
NC1841247442Medicaid
NCNC3148AMedicare PIN
NC2745068Medicare PIN
NC2745068AMedicare PIN