Provider Demographics
NPI:1962060459
Name:CALLAGHAN, VERONICA (RN)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:CALLAGHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 SE CAMANO DR
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-8367
Mailing Address - Country:US
Mailing Address - Phone:360-932-6939
Mailing Address - Fax:
Practice Address - Street 1:1385 SE CAMANO DR
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-8367
Practice Address - Country:US
Practice Address - Phone:360-932-6939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60082429163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty