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General NPI Number Information
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NPI Number | 1528509023
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Entity Type | Individual
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Provider Name | PATTY CALLISON FNP
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Gender | Female
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 11513 N MAIN ST
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City | JACKSONVILLE
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State | FL
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Zip | 32218-4002
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Country | US
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Telephone | 855-674-7400
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Fax | 904-730-1037
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Provider Business Mailing Address
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Address Line | 2675 WINKLER AVE FL 2
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City | FORT MYERS
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State | FL
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Zip | 33901-9342
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Country | US
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Telephone | 877-856-3774
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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 | APRN3262652
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License Number State | FL
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