Individual
TIA M CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 NORTH ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6621
(570) 271-6762
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN514776L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01023888
RR MEDICARE
PA
Enumeration date
10/25/2006
Last updated
03/13/2024
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