Provider Demographics
NPI:1811715816
Name:CALLAHAN, DEIRDRE MARGARET (DNP, WHNP-BC)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:MARGARET
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:DNP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HANOVER ST STE 2E
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5451
Mailing Address - Country:US
Mailing Address - Phone:508-673-2400
Mailing Address - Fax:
Practice Address - Street 1:300 HANOVER ST STE 2E
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5451
Practice Address - Country:US
Practice Address - Phone:508-673-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2378659363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health