MEDICARE: CARLOS MANUEL CALDERA FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	2022042299	MO

General Provider Information

NPI Number	:	1528775186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS MANUEL CALDERA FNP-BC

Provider Business Mailing Address
First Line	:	1950 DIAMOND PKWY
Second Line	:
City	:	NORTH KANSAS CITY
State	:	MO
Zip	:	64116-4328
Country	:	US
Telephone Number	:	816-501-3003
Fax Number	:

Provider Business Practice Location Address
First Line	:	1950 DIAMOND PKWY
Second Line	:
City	:	NORTH KANSAS CITY
State	:	MO
Zip	:	64116-4328
Country	:	US
Telephone Number	:	816-501-3003
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2022
Last Update Date	:	12/02/2025

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