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General NPI Number Information
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NPI Number | 1699135533
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Entity Type | Individual
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Provider Name | MICHAELA ERIN CALHOUN C.C.A.
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Gender | Female
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 1880 LIVINGSTON AVE STE 103
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City | WEST SAINT PAUL
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State | MN
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Zip | 55118-3426
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Country | US
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Telephone | 651-340-5594
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Fax | 844-632-5594
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Provider Business Mailing Address
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Address Line | 1880 LIVINGSTON AVE STE 103
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City | WEST SAINT PAUL
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State | MN
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Zip | 55118-3426
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Country | US
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Telephone | 651-340-5594
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Fax | 844-632-5594
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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 | 229N00000X
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Taxonomy Name | Anaplastologist
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License Number |
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License Number State |
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