Krystle Callan
Nurse Practitioner, Adult Health in West Islip, NY. Individual provider (NPI-1).
NPI number1497592299
StatusActive
Last updated in NPPESJul 10, 2024
Details
- NPI
- 1497592299
- Entity type
- Individual (NPI-1)
- Name
- Krystle Callan
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 10, 2024
- Certification date
- Jul 10, 2024
- Last updated
- Jul 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2200X | Nurse Practitioner, Adult Health | F311860-01 | NY | Yes |
Practice location
111 Beach DrWest Islip, NY 11795-4929
Phone 631-417-8643
Mailing address
195 Massachusetts AveMassapequa, NY 11758-4218
Phone 516-737-2093
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