Provider Demographics
NPI:1245129634
Name:ANDERSON, CALLEEN
Entity type:Individual
Prefix:
First Name:CALLEEN
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-4822
Mailing Address - Country:US
Mailing Address - Phone:515-298-4171
Mailing Address - Fax:
Practice Address - Street 1:1106 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-4822
Practice Address - Country:US
Practice Address - Phone:515-298-4171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider