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Individual
KORNNISA MCCALLON
Active
Individual
KORNNISA MCCALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
95023549
CA
363LF0000X
Family Nurse Practitioner
Primary
95023549
CA
363LP2300X
Primary Care Nurse Practitioner
95023549
CA
Other
Enumeration date
05/10/2023
Last updated
03/14/2025
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