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General NPI Number Information
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NPI Number | 1427842954
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Entity Type | Individual
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Provider Name | SEAN CALAVAN
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Gender | Male
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 4300 BARTLETT ST
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City | HOMER
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State | AK
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Zip | 99603-7000
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Country | US
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Telephone | 907-235-8101
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Fax |
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Provider Business Mailing Address
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Address Line | 4470 EMERADE CT
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City | HOMER
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State | AK
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Zip | 99603-8308
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Country | US
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Telephone | 209-419-1857
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 165867
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License Number State | AK
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