Doctor Name: | NITA L CALVIN |
NPI Number: | 1518983816 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 1217 |
Business Practice Address: | 710 S 13th Blackwell, OK - 74631 |
Business Phone Number: | 5803639473 |
Business Fax Number: | |
Mailing Address: | 601 Hunt Club Rd, BLANCHARD |
State: | OK |
Postal Code: | 730105063 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/14/2006 |
NPI Last Update Date: | 11/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1217 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |