Provider Demographics
NPI:1174066237
Name:CALDERON, SHEILA (CNP, FNP, RN)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:F
Credentials:CNP, FNP, RN
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:ANN
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:323 WILLAMOR CIR
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-1473
Mailing Address - Country:US
Mailing Address - Phone:507-951-6957
Mailing Address - Fax:
Practice Address - Street 1:323 WILLAMOR CIR
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-1473
Practice Address - Country:US
Practice Address - Phone:507-951-6957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 4571363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily