Provider Demographics
NPI:1649164302
Name:CALMES, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:CALMES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 E LOURDES DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-3927
Mailing Address - Country:US
Mailing Address - Phone:920-851-2345
Mailing Address - Fax:
Practice Address - Street 1:4236 N SHADYWOOD CT
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-2318
Practice Address - Country:US
Practice Address - Phone:920-851-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18319311ZA0620X
311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home