Provider Demographics
NPI:1255560736
Name:CALONDER, EMILY M (NP-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:CALONDER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 TEAL AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7111
Mailing Address - Country:US
Mailing Address - Phone:920-517-1473
Mailing Address - Fax:
Practice Address - Street 1:1660 SUE ALAN DR
Practice Address - Street 2:
Practice Address - City:WITTENBERG
Practice Address - State:WI
Practice Address - Zip Code:54499-8655
Practice Address - Country:US
Practice Address - Phone:715-253-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIF0609176363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily