Provider Demographics
NPI:1669085395
Name:CALDERON, EMILY (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:CALDERON
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5556 N SHERIDAN RD APT 506
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1677
Mailing Address - Country:US
Mailing Address - Phone:801-898-2496
Mailing Address - Fax:
Practice Address - Street 1:14629 S PORTER ROCKWELL BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:BLUFFDALE
Practice Address - State:UT
Practice Address - Zip Code:84065
Practice Address - Country:US
Practice Address - Phone:801-898-2496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9518840-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner