Provider Demographics
NPI:1124442488
Name:CODY, SALLY IRENE (FNP)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:IRENE
Last Name:CODY
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 1:52 RUEL HALL RD
Mailing Address - Street 2:
Mailing Address - City:HAYESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28904-7108
Mailing Address - Country:US
Mailing Address - Phone:828-361-6599
Mailing Address - Fax:
Practice Address - Street 1:241 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAYESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28904-9688
Practice Address - Country:US
Practice Address - Phone:828-389-6383
Practice Address - Fax:828-389-6803
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006731363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care