Provider Demographics
NPI:1164729729
Name:DINGLER, CALLY MCKEMIE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:CALLY
Middle Name:MCKEMIE
Last Name:DINGLER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:CALLY
Other - Middle Name:MCKEMIE
Other - Last Name:CLAUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:503 HILL STREET
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904
Mailing Address - Country:US
Mailing Address - Phone:936-632-1139
Mailing Address - Fax:936-633-0661
Practice Address - Street 1:503 HILL STREET
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904
Practice Address - Country:US
Practice Address - Phone:936-632-1139
Practice Address - Fax:936-633-0661
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX716790363LP0200X
TXAP119996363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics