Individual
SANDRA L. SCALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4239
(704) 384-5636
Mailing address
PO BOX 601549, CHARLOTTE, NC 28260-1549
(704) 384-4239
(704) 384-5636
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
027908
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050836
—
NC
05
—
NAN096
—
SC
Enumeration date
06/05/2006
Last updated
04/01/2013
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