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Individual

MS. MELISSA D. CALLAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
5950 STATE ROUTE 6, TUNKHANNOCK, PA 18657
(570) 836-2161
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN242500L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
543062
MEDICARE
PA
01
543062VKC
MEDICARE (NOVITAS)
PA
Enumeration date
04/11/2006
Last updated
07/10/2017
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