Provider Demographics
NPI:1912359563
Name:CALLEY, JOSHUA DAVID (RN FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DAVID
Last Name:CALLEY
Suffix:
Gender:M
Credentials:RN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 BUSINESS PKWY STE F
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6349
Mailing Address - Country:US
Mailing Address - Phone:866-799-5886
Mailing Address - Fax:
Practice Address - Street 1:6675 BUSINESS PKWY STE F
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6349
Practice Address - Country:US
Practice Address - Phone:866-799-5886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340763363LF0000X
NY658301163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00340763Medicaid
NY0F340763Medicaid