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General NPI Number Information
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NPI Number | 1518508555
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Entity Type | Individual
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Provider Name | JESSE JAMES CALLAHAN RN
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Gender | Male
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | JERRI-JEAN MILLER CLINICAL STAFF AFFAIRS VA HEALTHCARE SYSTEM
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City | BAY PINES
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State | FL
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Zip | 33744
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Country | US
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Telephone | 727-398-6661
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Fax | 727-319-1252
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Provider Business Mailing Address
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Address Line | 6912 CURTISS AVE
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City | SARASOTA
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State | FL
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Zip | 34231-8128
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Country | US
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Telephone | 774-205-4937
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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 | RN9510099
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License Number State | FL
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