Provider Demographics
NPI:1891077665
Name:CALCUT, JEAN MARIE (CRNP - FNPBC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:CALCUT
Suffix:
Gender:F
Credentials:CRNP - FNPBC
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:MARIE
Other - Last Name:COULTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:217 HARRISBURG AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2964
Mailing Address - Country:US
Mailing Address - Phone:717-544-8312
Mailing Address - Fax:
Practice Address - Street 1:217 HARRISBURG AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2964
Practice Address - Country:US
Practice Address - Phone:717-544-8312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR161319363LF0000X
PASP012127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP012127OtherNP LICENSE