Provider Demographics
NPI:1740218288
Name:CALHOUN, DENISE L (CRNA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9500
Mailing Address - Country:US
Mailing Address - Phone:704-660-4434
Mailing Address - Fax:704-660-4405
Practice Address - Street 1:171 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9500
Practice Address - Country:US
Practice Address - Phone:704-660-4434
Practice Address - Fax:704-660-4405
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC89721367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered