Provider Demographics
NPI:1982675971
Name:MESSICK, SALLY CARSON (FNP)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:CARSON
Last Name:MESSICK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743
Mailing Address - Street 2:788 HOLLY RIDGE ROAD
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-0743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34575 US HWY 264
Practice Address - Street 2:
Practice Address - City:ENGELHARD
Practice Address - State:NC
Practice Address - Zip Code:27824-0277
Practice Address - Country:US
Practice Address - Phone:252-925-7000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003670Medicaid
NCE2274OtherMED COST
NC2802213BMedicare ID - Type Unspecified
NC7003670Medicaid