Provider Demographics
NPI:1619162997
Name:MCCALL, NADINE M (NP)
Entity Type:Individual
Prefix:MRS
First Name:NADINE
Middle Name:M
Last Name:MCCALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NADINE
Other - Middle Name:M
Other - Last Name:EARLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 SHATTUCK WAY
Mailing Address - Street 2:STE 100
Mailing Address - City:NEWINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03801-8007
Mailing Address - Country:US
Mailing Address - Phone:603-431-6677
Mailing Address - Fax:603-610-7713
Practice Address - Street 1:100 SHATTUCK WAY
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:NH
Practice Address - Zip Code:03801-8004
Practice Address - Country:US
Practice Address - Phone:603-431-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2023-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081033363LF0000X
NH058235-23363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P34474Medicare UPIN
ME000324201Medicare PIN