Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 0024168387 | VA |
NPI | 1003107376 |
---|---|
Provider Name | Magen Calland |
First Address | Lynchburg, VA 24502-2112 |
Second Address | Lynchburg, VA 24503-2030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2011 |
Last Update Date | 21/04/2011 |