Individual
LEANN DAWN CALVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
619 S FLEISHEL AVE STE 100, TYLER, TX 75701-2004
(903) 606-2830
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP135544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381756102
—
TX
01
—
P02210699
MEDICARE RAIL ROAD
TX
Enumeration date
10/20/2017
Last updated
05/21/2019
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