Provider Demographics
NPI:1508887613
Name:CALCIANO, KRISTEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:
Last Name:CALCIANO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 STOCKDALE HWY
Mailing Address - Street 2:#203
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3620
Mailing Address - Country:US
Mailing Address - Phone:661-664-0252
Mailing Address - Fax:661-664-2717
Practice Address - Street 1:9500 STOCKDALE HWY
Practice Address - Street 2:#203
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3620
Practice Address - Country:US
Practice Address - Phone:661-664-0252
Practice Address - Fax:661-664-2717
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467626363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG00886Medicare UPIN