Healthcare Provider Details

I. General information

NPI: 1043034770
Provider Name (Legal Business Name): LINDA JACQUELINE CALCATERRA BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 11/11/2024
Certification Date: 11/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 MAIN ST
MARLETTE MI
48453-1141
US

IV. Provider business mailing address

2770 MAIN ST
MARLETTE MI
48453-1141
US

V. Phone/Fax

Practice location:
  • Phone: 989-559-1411
  • Fax:
Mailing address:
  • Phone: 989-559-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number4704341989
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: