Provider Demographics
NPI:1043734429
Name:MCCALL, LAURA ANN ELIZABETH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN ELIZABETH
Last Name:MCCALL
Suffix:
Gender:F
Credentials:FNP-BC
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:AGAPE SENIOR PRIMARY CARE INC DBA LTC HEALTH SOLUTIONS
Mailing Address - Street 2:1624 MAIN STREET
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2818
Mailing Address - Country:US
Mailing Address - Phone:803-726-2350
Mailing Address - Fax:803-753-9102
Practice Address - Street 1:DBA LTC HEALTH SOLUTIONS
Practice Address - Street 2:110 GARDNER DR
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926
Practice Address - Country:US
Practice Address - Phone:800-491-0909
Practice Address - Fax:843-353-2581
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC21136363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily