Healthcare Provider Details

I. General information

NPI: 1407719396
Provider Name (Legal Business Name): ELIZABETH ANN CALLOWAY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH USHER

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 09/29/2026
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 BENNETT DR
ALBANY GA
31705-6433
US

IV. Provider business mailing address

137 BENNETT DR
ALBANY GA
31705-6433
US

V. Phone/Fax

Practice location:
  • Phone: 229-296-9237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN336017
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: