Provider Demographics
NPI:1376891606
Name:CALDWELL, ALTAMEASE (RN)
Entity Type:Individual
Prefix:
First Name:ALTAMEASE
Middle Name:
Last Name:CALDWELL
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:PO BOX 35465
Mailing Address - Street 2:
Mailing Address - City:ST.PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-0508
Mailing Address - Country:US
Mailing Address - Phone:813-380-9843
Mailing Address - Fax:
Practice Address - Street 1:1239 4TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:ST.PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705
Practice Address - Country:US
Practice Address - Phone:727-202-8933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9261582163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health