Provider Demographics
NPI:1740424357
Name:ISBELL, SARAH MOORE (NP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MOORE
Last Name:ISBELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP-C
Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:8 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-8005
Practice Address - Country:US
Practice Address - Phone:803-256-6511
Practice Address - Fax:803-744-4731
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3322363L00000X, 363LA2200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3322OtherMEDICAL LICENSE
SCNP1409Medicaid