Elma F Callis

Individual provider Active NPI Nurse Practitioner · Rutherfordton, NC

NPI 1093048522 · NPPES record last updated Jun 19, 2014

Key facts

NPI
1093048522
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
5004478 (NC)
Practice address
288 S Ridgecrest Ave
Rutherfordton, NC 28139-2838
Phone
(828) 286-5508
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5004478NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rutherford Emergency Medicine PA Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004478 NC Yes

Addresses

Primary practice location

288 S Ridgecrest Ave
Rutherfordton, NC 28139-2838

Mailing address

PO Box 75358
Charlotte, NC 28275-0358
Phone (843) 237-3378

Other providers in Rutherfordton, NC

All providers in Rutherfordton, NC · Nurse Practitioner in North Carolina

Sources for this page

Verify at the official NPI Registry.