Gwendolyn Calhoon, FNP-C – Family Nurse Practitioner

Key facts

NPI: 1104296599
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: 1-129614 (AL)
Practice address: 1300 Highway 231 S
Troy, AL 36081-3058
Phone: (334) 566-7600
Fax: (334) 566-9181
NPI assigned: Sep 29, 2015
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.

Charles Henderson Memorial Association Clinic/Center · Troy, AL · NPI 1346207131

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
1-129614	AL	MD	Family Nurse Practitioner
RN221321	GA	MD	Family Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Charles Henderson Memorial Association		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	RN221321	GA
Family Nurse Practitioner	363LF0000X	1-129614	AL	Yes

Addresses

Primary practice location

1300 Highway 231 S
Troy, AL 36081-3058

Mailing address

PO Box 928
Troy, AL 36081-0928
Phone (334) 566-7600

Other identifiers

Identifier	Type	State	Issuer
196996	Medicaid	AL

Other providers in Troy, AL

All providers in Troy, AL · Family Nurse Practitioner in Alabama

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2017. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.