Individual
CAROL L MACCALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4606 GRAY WOLF LN, CASTLE ROCK, CO 80104-3570
(720) 767-4686
Mailing address
4606 GRAY WOLF LN, CASTLE ROCK, CO 80104-3570
(720) 767-4686
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4174
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91082056
—
CO
01
—
C-APN4174
STATE NP LICENSE
CO
Enumeration date
07/16/2006
Last updated
02/12/2025
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