MEDICARE: ASHLEY MICHELLE GIBBS-SANDERS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5024099	NC
2	363LF0000X	Family Nurse Practitioner	28275	SC

General Provider Information

NPI Number	:	1285327163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MICHELLE GIBBS-SANDERS APRN

Provider Business Mailing Address
First Line	:	SC HOUSE CALLS INC
Second Line	:	111 DOCTORS CIR
City	:	COLUMBIA
State	:	SC
Zip	:	29203
Country	:	US
Telephone Number	:	800-491-0909
Fax Number	:

Provider Business Practice Location Address
First Line	:	SC HOUSE CALLS INC
Second Line	:	111 DOCTORS CIR
City	:	COLUMBIA
State	:	SC
Zip	:	29203
Country	:	US
Telephone Number	:	800-491-0909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2023
Last Update Date	:	03/17/2026

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