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General NPI Number Information
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NPI Number | 1659915163
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Entity Type | Individual
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Provider Name | ORLANDRA CALDWELL FNP
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Gender | Female
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Dates
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Enumeration Date | 10/29/2019
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 3849 NORTHRIDGE DR
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City | ROCKFORD
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State | IL
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Zip | 61114-4773
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Country | US
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Telephone | 815-329-6909
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Fax | 779-201-3171
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Provider Business Mailing Address
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Address Line | PO BOX 6037
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City | WAUCONDA
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State | IL
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Zip | 60084-6037
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Country | US
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Telephone | 847-526-2151
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Fax | 847-526-2017
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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 | 209020164
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License Number State | IL
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