Penelope Fay Callaway, FNP-C

Individual provider Active NPI Family Nurse Practitioner · Brazil, IN

NPI 1487813085 · NPPES record last updated Jun 9, 2008

Key facts

NPI
1487813085
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
71002646A (IN)
Practice address
1214 E National Ave Ste 100
Brazil, IN 47834-2700
Phone
(812) 442-2100
NPI assigned
Jun 9, 2008
Sex
Female
Sole proprietor
No

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
71002646AINMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71002646A IN Yes

Addresses

Primary practice location

1214 E National Ave Ste 100
Brazil, IN 47834-2700

Mailing address

1214 E National Ave Ste 100
Brazil, IN 47834-2700
Phone (812) 442-2100

Other providers in Brazil, IN

All providers in Brazil, IN · Family Nurse Practitioner in Indiana

Sources for this page

Verify at the official NPI Registry.