Provider Demographics
NPI:1285373175
Name:CALDERON, LEAH KAY (FNP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:KAY
Last Name:CALDERON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:KAY
Other - Last Name:CHERRIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11217 W TAMMY DR
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21813-1640
Mailing Address - Country:US
Mailing Address - Phone:757-990-1031
Mailing Address - Fax:
Practice Address - Street 1:900 ELKRIDGE LANDING RD
Practice Address - Street 2:
Practice Address - City:LINTHICUM HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21090-2924
Practice Address - Country:US
Practice Address - Phone:410-706-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR234374207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty