Individual
DANIELLE MARIE CALLANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2647 BOX CANYON DR, LAS VEGAS, NV 89128-0450
(702) 363-5575
Mailing address
2647 BOX CANYON DR, LAS VEGAS, NV 89128-0450
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2035
NV
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699256388
—
NV
01
—
PA2035
STATE LICENSE
NV
Enumeration date
08/22/2018
Last updated
03/14/2024
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