Basic Information
| Provider Information | |||||||||
| NPI: | 1659324226 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCALLUM | ||||||||
| FirstName: | ANINE | ||||||||
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| Credential: | APRN, FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 S WINCHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | MILES CITY | ||||||||
| State: | MT | ||||||||
| PostalCode: | 593014757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062348793 | ||||||||
| FaxNumber: | 4062348796 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 WILSON ST | ||||||||
| Address2: | |||||||||
| City: | MILES CITY | ||||||||
| State: | MT | ||||||||
| PostalCode: | 593015094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062332500 | ||||||||
| FaxNumber: | 4062332553 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LC1500X | 70410 | MT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Community Health |
No ID Information.