Provider Demographics
NPI:1790028975
Name:CALLENS, MARY THERESE ACFALLE (CRNP)
Entity Type:Individual
Prefix:DR
First Name:MARY THERESE
Middle Name:ACFALLE
Last Name:CALLENS
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:6269 KESTRAL VIEW RD
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-6318
Mailing Address - Country:US
Mailing Address - Phone:205-975-5595
Mailing Address - Fax:205-934-0655
Practice Address - Street 1:176 7FL RM 7301F
Practice Address - Street 2:619 19TH ST S
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-7404
Practice Address - Country:US
Practice Address - Phone:205-975-5595
Practice Address - Fax:205-934-0655
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2023-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL1-096719363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily