Provider Demographics
NPI:1235982653
Name:CALLISTER, ERIN SUSANN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:SUSANN
Last Name:CALLISTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3689 CASHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-7401
Mailing Address - Country:US
Mailing Address - Phone:775-742-2034
Mailing Address - Fax:
Practice Address - Street 1:3689 CASHILL BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-7401
Practice Address - Country:US
Practice Address - Phone:775-742-2034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program