Individual
SCOTT A CALVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APNP
Contact information
Practice address
145 N MAIN ST, FOND DU LAC, WI 54935-3423
(920) 926-8492
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8492
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10259-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10259-33
STATE LICENSE - APNP
WI
01
—
130045-30
STATE LICENSE - RN
WI
Enumeration date
09/22/2020
Last updated
12/08/2020
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