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General NPI Number Information
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NPI Number | 1982578753
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Entity Type | Individual
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Provider Name | CALVIN LEE THORNTON PMHNP
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Gender | Male
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 703 PRO MED LN
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City | CARMEL
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State | IN
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Zip | 46032-5317
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Country | US
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Telephone | 317-843-9922
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Fax | 317-581-3918
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Provider Business Mailing Address
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Address Line | 703 PRO MED LN
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City | CARMEL
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State | IN
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Zip | 46032-5317
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Country | US
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Telephone | 317-843-9922
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Fax | 317-581-3918
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71017215B
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28226452A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71017215A
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License Number State | IN
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