Provider Demographics
NPI:1972198109
Name:CALLWOOD, ANGELA ERICA (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ERICA
Last Name:CALLWOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MCKAY ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND CITY
Mailing Address - State:AR
Mailing Address - Zip Code:71839-8848
Mailing Address - Country:US
Mailing Address - Phone:903-949-5271
Mailing Address - Fax:
Practice Address - Street 1:405 MCKAY ST
Practice Address - Street 2:
Practice Address - City:GARLAND CITY
Practice Address - State:AR
Practice Address - Zip Code:71839-8848
Practice Address - Country:US
Practice Address - Phone:903-949-5271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR109465163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics