Provider Demographics
NPI:1720585177
Name:CALTON, NANCY ANN (FNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:CALTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 LOTUS RD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-9492
Mailing Address - Country:US
Mailing Address - Phone:916-296-0070
Mailing Address - Fax:
Practice Address - Street 1:1580 LOTUS RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-9492
Practice Address - Country:US
Practice Address - Phone:530-344-8283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008593363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner