Provider Demographics
NPI:1538852728
Name:CALL, CARISSA (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:CARISSA
Middle Name:
Last Name:CALL
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15210 COUNTY ROAD 10 3
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:OH
Mailing Address - Zip Code:43533-9713
Mailing Address - Country:US
Mailing Address - Phone:419-262-3316
Mailing Address - Fax:
Practice Address - Street 1:7537 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9617
Practice Address - Country:US
Practice Address - Phone:614-333-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0033898207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine