Provider Demographics
NPI:1386015816
Name:MCCALLA, EKUA (ARNP)
Entity Type:Individual
Prefix:
First Name:EKUA
Middle Name:
Last Name:MCCALLA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S MAPLE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4243
Mailing Address - Country:US
Mailing Address - Phone:703-532-5436
Mailing Address - Fax:703-532-3232
Practice Address - Street 1:400 S MAPLE AVE STE 200
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4243
Practice Address - Country:US
Practice Address - Phone:703-532-5436
Practice Address - Fax:703-532-3232
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9289270363L00000X
VA0024174819363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner