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General NPI Number Information
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NPI Number | 1184888448
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Entity Type | Individual
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Provider Name | LAURIE A. MCCALL FAMILY NURSE PRACTIT
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Gender | Female
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 9900 BREN RD EAST MAIL ROUTE MN 008-B213
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City | MINNETONKA
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State | MN
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Zip | 55343
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Country | US
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Telephone | 229-589-0272
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Fax |
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Provider Business Mailing Address
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Address Line | 156 GEO DR
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City | CLARKESVILLE
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State | GA
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Zip | 30523-1603
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Country | US
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Telephone | 229-456-1956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN093653NP
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 093653
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 096653
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License Number State | GA
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