Provider Demographics
NPI:1710953096
Name:MCCALL, NANCY (MS,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 GLEN OAK DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1705
Mailing Address - Country:US
Mailing Address - Phone:919-734-1773
Mailing Address - Fax:919-581-0023
Practice Address - Street 1:205 GLEN OAK DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1705
Practice Address - Country:US
Practice Address - Phone:919-734-1773
Practice Address - Fax:919-581-0023
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1253235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC55691OtherBCBS INDIVIDUAL
NC7455691Medicaid