Provider Demographics
NPI:1215712278
Name:CALLIER, MICHELLE ERICA
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ERICA
Last Name:CALLIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 ARBOR CIR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1916
Mailing Address - Country:US
Mailing Address - Phone:330-999-2096
Mailing Address - Fax:
Practice Address - Street 1:529 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44511-1558
Practice Address - Country:US
Practice Address - Phone:330-999-2096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN521855163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse