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NPI Code Detail

MEDICARE: CALIFORNIA LENEE CALDWELL RN, MSN, PMHNP-BC

MEDICARE: CALIFORNIA LENEE CALDWELL RN, MSN, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner0024182329VA

General Provider Information

NPI Number : 1164196523
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALIFORNIA LENEE CALDWELL RN, MSN, PMHNP-BC
Provider Business Mailing Address
First Line : 120 W COMMERCE ST
Second Line :
City : AMHERST
State : VA
Zip : 24521-1115
Country : US
Telephone Number : 434-946-2316
Fax Number :
Provider Business Practice Location Address
First Line : 120 W COMMERCE ST
Second Line :
City : AMHERST
State : VA
Zip : 24521-1115
Country : US
Telephone Number : 434-946-2316
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2021
Last Update Date : 05/08/2024

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