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Individual
BREIDI A. CALLOWAY
Active
Individual
BREIDI A. CALLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
18343
CA
261QX0200X
Oncology Clinic/Center
18343
CA
363L00000X
Nurse Practitioner
Primary
18343
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902846306
GROUP NPI
CA
01
—
GR0100430
GROUP MEDICAL
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
12/23/2010
Last updated
04/03/2012
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