Individual
MR. CHARLES PORTER SLOAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2101 KEN PRATT BLVD STE 200, LONGMONT, CO 80501-6568
(303) 649-3500
(303) 649-3501
Mailing address
4672 W 20TH STREET RD UNIT 2011, GREELEY, CO 80634-8401
(970) 402-3330
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN.0996481-NP
CO
363L00000X
Nurse Practitioner
RXN.0105559-NP
CO
364S00000X
Clinical Nurse Specialist
APN.0994548-CNS
CO
364S00000X
Clinical Nurse Specialist
RN.0199010
CO
364S00000X
Clinical Nurse Specialist
RXN.0103920-CNS
CO
Other
Enumeration date
04/11/2019
Last updated
05/04/2021
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