Healthcare Provider Details

I. General information

NPI: 1487300596
Provider Name (Legal Business Name): SALLY ANN BISSELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SALLY ANN MURPHY

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 06/12/2022
Certification Date: 06/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 FIRST STREET, SUITE C SC HOUSE CALLS INC/GA HOUSE CALLS INC
MACON GA
31201
US

IV. Provider business mailing address

1053 CENTER STREET SC HOUSE CALLS INC
WEST COLUMBIA SC
29169
US

V. Phone/Fax

Practice location:
  • Phone: 800-491-0909
  • Fax:
Mailing address:
  • Phone: 800-491-0909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN249010
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN249010
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: