Provider Demographics
NPI:1063665578
Name:CALLAHAM, NANCY MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MARIE
Last Name:CALLAHAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS PLZ
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1898
Mailing Address - Country:US
Mailing Address - Phone:937-641-3000
Mailing Address - Fax:937-641-5076
Practice Address - Street 1:1 CHILDRENS PLZ
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1898
Practice Address - Country:US
Practice Address - Phone:937-641-3000
Practice Address - Fax:937-641-5076
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH184319163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management