Individual
JACQUELINE MARIE SLOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3906 WAKE FOREST RD, RALEIGH, NC 27609-6867
(716) 880-4413
(919) 350-7687
Mailing address
3906 WAKE FOREST RD, RALEIGH, NC 27609-6867
(716) 880-4413
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-10871
NC
363AM0700X
Medical Physician Assistant
0010-10871
NC
363AS0400X
Surgical Physician Assistant
0010-10871
NC
Other
Enumeration date
04/29/2020
Last updated
10/15/2024
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