Provider Demographics
NPI:1497920649
Name:CALHOUN, MIKELYN (RN, BSN,CDE)
Entity Type:Individual
Prefix:MRS
First Name:MIKELYN
Middle Name:
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:RN, BSN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 LINN STATION RD
Mailing Address - Street 2:SUITE 560
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3848
Mailing Address - Country:US
Mailing Address - Phone:502-657-0440
Mailing Address - Fax:502-657-0041
Practice Address - Street 1:200 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066
Practice Address - Country:US
Practice Address - Phone:334-361-6380
Practice Address - Fax:334-220-3590
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1078255163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator