Provider Demographics
NPI:1265293450
Name:SELLERS, CALLIE POOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:POOLE
Last Name:SELLERS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 HIGHWAY 85
Mailing Address - Street 2:
Mailing Address - City:CHANCELLOR
Mailing Address - State:AL
Mailing Address - Zip Code:36316-1100
Mailing Address - Country:US
Mailing Address - Phone:229-221-2956
Mailing Address - Fax:
Practice Address - Street 1:287 HEALTHWEST DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2031
Practice Address - Country:US
Practice Address - Phone:334-792-9500
Practice Address - Fax:334-793-1815
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-138867363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily