Healthcare Provider Details

I. General information

NPI: 1487095063
Provider Name (Legal Business Name): SALLY INGLIS APRN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 EMBARCADERO CTR LBBY LEVEL
SAN FRANCISCO CA
94111-3823
US

IV. Provider business mailing address

1 EMBARCADERO CTR STE 19
SAN FRANCISCO CA
94111-3628
US

V. Phone/Fax

Practice location:
  • Phone: 415-578-3100
  • Fax:
Mailing address:
  • Phone: 415-658-6791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18846
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: