Provider Demographics
NPI:1023602687
Name:MEDCALF, LORNA LYNN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LORNA
Middle Name:LYNN
Last Name:MEDCALF
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:10521 JEFFREYS ST STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4181
Practice Address - Country:US
Practice Address - Phone:702-269-6345
Practice Address - Fax:702-269-9422
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV836360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV839813OtherSTATE LICENSE
NV1023602687Medicaid
NV836360OtherSTATE LICENSE