Provider Demographics
NPI:1598363137
Name:CALDER, MARVA SYLVIA (NP)
Entity Type:Individual
Prefix:
First Name:MARVA
Middle Name:SYLVIA
Last Name:CALDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 STALLINGS ST NW # 567
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2351
Mailing Address - Country:US
Mailing Address - Phone:404-273-0835
Mailing Address - Fax:
Practice Address - Street 1:2131 STALLINGS ST NW # 567
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2351
Practice Address - Country:US
Practice Address - Phone:404-273-0835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN146782363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty