Provider Information for 1184394215
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Mrs. DEANDRA MILAM CALVIN
Sex: Female
NPI: 1184394215
Last Updated: 2024-09-04
Certification Date: 2024-09-04
Certification Date: 2024-09-04
Details
| Name | Value | ||||||||||||||||
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| NPI | 1184394215 | ||||||||||||||||
| Enumeration Date | 2021-09-20 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 6332 SANDBOURNE W OLIVE BRANCH, MS 38654-6562 United States Phone: 901-230-4305 | Fax: | ||||||||||||||||
| Primary Practice Address | 1321 MURFREESBORO PIKE STE 511 NASHVILLE, TN 37217-2626 United States Phone: 615-938-0527 | Fax: | ||||||||||||||||
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