Carolyn Kay Calvin, WHCNP/ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

200150122NP Issued in OR

Practice address

325TH Medical Group
340 Magnolia Circle
Tyndall Afb, FL 32403-5604

Phone

(850) 283-7491

NPI assigned

Nov 19, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1508848904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 ASHLAND WAY",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324044277",
            "telephone_number": "808-778-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325TH MEDICAL GROUP",
            "address_2": "340 MAGNOLIA CIRCLE",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALVIN",
        "first_name": "CAROLYN",
        "middle_name": "KAY",
        "credential": "WHCNP/ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-19",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "200150121NP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "200150122NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea C Bright, LCSW
• Trish Phu Bui, RPH
• Xhosa R Burford, LCSW
• Bruce Alan Burkett, D.O.
• Zachary Cabana, DPT
• Walter Edward Calvo, DCSW
• Zachary Caleb Camacho, DMD
• David O Campbell, PHARM D
• Matthew Russel Checketts, D.D.S.
• Nathaniel Criddle, DMD

• Adult Health Nurse Practitioner in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.