Provider Demographics
NPI:1912325572
Name:CALDERON, CECILIA ANN (NP-C)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:ANN
Last Name:CALDERON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 W CRESTA LOMA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3704
Mailing Address - Country:US
Mailing Address - Phone:520-240-3689
Mailing Address - Fax:
Practice Address - Street 1:4365 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1633
Practice Address - Country:US
Practice Address - Phone:520-407-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily