Provider Demographics
NPI:1063662708
Name:CALLIGAN, CLAUDINE PATRICIA (MS, FNP-C, CNM,)
Entity Type:Individual
Prefix:
First Name:CLAUDINE
Middle Name:PATRICIA
Last Name:CALLIGAN
Suffix:
Gender:F
Credentials:MS, FNP-C, CNM,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6965 E GRANADA ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-6932
Mailing Address - Country:US
Mailing Address - Phone:480-286-0663
Mailing Address - Fax:
Practice Address - Street 1:504 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5627
Practice Address - Country:US
Practice Address - Phone:480-286-0663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN139402163W00000X
AZAP3473367A00000X
AZAP3064363LF0000X
AZLM110175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No175M00000XOther Service ProvidersMidwife, Lay
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZMC1862374OtherDEA