Provider Demographics
NPI:1225637168
Name:CALLANDER, CHRISTINE LYN SMULLIN (APRN FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYN SMULLIN
Last Name:CALLANDER
Suffix:
Gender:F
Credentials:APRN FNP
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:LYN
Other - Last Name:CALLANDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN FNP
Mailing Address - Street 1:5172 VILLAGE CREEK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4444
Mailing Address - Country:US
Mailing Address - Phone:972-332-1930
Mailing Address - Fax:855-554-0995
Practice Address - Street 1:5172 VILLAGE CREEK DR STE 101
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4444
Practice Address - Country:US
Practice Address - Phone:972-332-1930
Practice Address - Fax:855-554-0995
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1017582363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1017582OtherTEXAS STATE BON