Staley, Sallie Lynn

Staley, Sallie Lynn is an individual health care provider with primary practice located at 1908 Caudle Dr Ste 200 , Mount Airy NC 27030-4322. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Staley, Sallie Lynn can be contacted via phone (336) 783-6935.

Contact Information

Primary practice address
1908 Caudle Dr Ste 200 Mount Airy NC 27030-4322
Phone: (336) 783-6935
Fax: (336) 783-6934
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 001000117 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0010-00117 North Carolina

Profile Details

NPI number 1821068768
LBN Legal business name Staley, Sallie Lynn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Sep 22nd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821068768 NPPES
North Carolina MEDICAID 8101699

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