Provider Demographics
NPI:1083965347
Name:CALDERON, THERESA (DNP APRN FNP-C)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:F
Credentials:DNP APRN FNP-C
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN; RN
Mailing Address - Street 1:1650 COWLES ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-5907
Mailing Address - Country:US
Mailing Address - Phone:907-458-6450
Mailing Address - Fax:907-458-6430
Practice Address - Street 1:115 OVERLAND DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4053
Practice Address - Country:US
Practice Address - Phone:864-227-6641
Practice Address - Fax:864-227-3953
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK142059363LF0000X
SC25802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily