Healthcare Provider Details

I. General information

NPI: 1235769985
Provider Name (Legal Business Name): MICHELLE BRACK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SC HOUSE CALLS, INC. 111 DOCTORS CIR.
COLUMBIA SC
29203
US

IV. Provider business mailing address

SC HOUSE CALLS, INC. 111 DOCTORS CIR.
COLUMBIA SC
29203
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 NumberRN173440
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN173440
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: