Provider Demographics
NPI:1063097988
Name:CALAN, KACE L (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KACE
Middle Name:L
Last Name:CALAN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:KACE
Other - Middle Name:L
Other - Last Name:DUGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3618 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-2539
Mailing Address - Country:US
Mailing Address - Phone:936-205-9922
Mailing Address - Fax:936-205-9923
Practice Address - Street 1:3618 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-2539
Practice Address - Country:US
Practice Address - Phone:936-205-9922
Practice Address - Fax:936-205-9923
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK201051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX40932OtherTEXAS APRN-CNP PRESCRIPTIVE AUTHORITY
TX1055482OtherTEXAS APRN-CNP LICENSE/CERTIFICATE
F01210577OtherAANP CERTIFICATION
OK201051OtherOKLAHOMA APRN-CNP LICENSE/CERTIFICATE