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General NPI Number Information
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NPI Number | 1659464576
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Entity Type | Individual
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Provider Name | PATRICIA LEANN CALVERT CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 117 SECOND AVE SE
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City | CULLMAN
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State | AL
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Zip | 35055-3511
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Country | US
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Telephone | 256-739-4144
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Fax | 256-739-4595
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Provider Business Mailing Address
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Address Line | 117 SECOND AVE SE
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City | CULLMAN
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State | AL
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Zip | 35055-3511
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Country | US
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Telephone | 256-739-4144
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Fax | 256-739-4595
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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 | 1069394
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License Number State | AL
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