Individual
CRAIG F CALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-BC
Contact information
Practice address
11555 1/2 POTRERO RD, BANNING, CA 92220-6946
(951) 849-4761
(951) 849-4651
Mailing address
11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5172
(909) 864-1097
(512) 256-8799
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9365661
FL
363L00000X
Nurse Practitioner
Primary
11006675
FL
363LF0000X
Family Nurse Practitioner
95239375
CA
363LF0000X
Family Nurse Practitioner
APRN11006675
FL
Other
Enumeration date
01/16/2020
Last updated
07/28/2024
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