Provider Demographics
NPI:1649228156
Name:CALLI, LINDA KAY (NP-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:CALLI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8208 ALLISONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1532
Mailing Address - Country:US
Mailing Address - Phone:317-849-1222
Mailing Address - Fax:317-577-5444
Practice Address - Street 1:8208 ALLISONVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1532
Practice Address - Country:US
Practice Address - Phone:317-849-1222
Practice Address - Fax:317-577-5444
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001227A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200356410Medicaid
IN200356410Medicaid
IN1187014Medicare PIN
IN200356410Medicaid