Provider Demographics
NPI:1568430734
Name:MCCALL, LENORA VIRGINIA (CNM, MSN,ARNP)
Entity Type:Individual
Prefix:MRS
First Name:LENORA
Middle Name:VIRGINIA
Last Name:MCCALL
Suffix:
Gender:F
Credentials:CNM, MSN,ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 MARINER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-2466
Mailing Address - Country:US
Mailing Address - Phone:352-263-2600
Mailing Address - Fax:352-684-2218
Practice Address - Street 1:4003 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-2466
Practice Address - Country:US
Practice Address - Phone:352-263-2600
Practice Address - Fax:352-684-2218
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22399272367A00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015500600Medicaid
FL850000200Medicaid