Healthcare Provider Details

I. General information

NPI: 1437064367
Provider Name (Legal Business Name): CHRISTINA LOUISE MCCALLUM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1492 W ANTELOPE DR STE 125
LAYTON UT
84041-1274
US

IV. Provider business mailing address

1492 W ANTELOPE DR STE 125
LAYTON UT
84041-1274
US

V. Phone/Fax

Practice location:
  • Phone: 801-525-3022
  • Fax: 801-267-5617
Mailing address:
  • Phone: 801-525-3022
  • Fax: 801-267-5617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number8278586-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: