| Doctor Name: | SALLY M PROFFITT |
| NPI Number: | 1023389210 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | R878145 |
| Business Practice Address: | 1024 D A Biglane Dr Brookhaven, MS - 396012331 |
| Business Phone Number: | 6018238000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1547, SEDALIA |
| State: | MO |
| Postal Code: | 653021547 |
| Phone Number: | 6608265960 |
| Fax Number: | 6608264852 |
| NPI Enumeration Date: | 01/19/2012 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R878145 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |