Individual
MALORY SELENA CALDERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGCNS-BC
Contact information
Practice address
919 E 32ND ST, AUSTIN, TX 78705
(512) 901-1000
Mailing address
3400 HARMON AVE APT 241, AUSTIN, TX 78705-2357
(512) 296-5112
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
882885
TX
363L00000X
Nurse Practitioner
AP134782
TX
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
AP134782
TX
Other
Enumeration date
07/28/2017
Last updated
10/11/2024
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