Provider Demographics
NPI:1053564849
Name:CALDERON, KATARZYNA (CRNP)
Entity type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4508 CHESTNUT ST
Mailing Address - Street 2:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-3608
Mailing Address - Country:US
Mailing Address - Phone:215-573-3632
Mailing Address - Fax:215-573-6848
Practice Address - Street 1:5838 GERMANTOWN AVE
Practice Address - Street 2:ST CATHERINE LABOURE MEDICAL CLINIC
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144
Practice Address - Country:US
Practice Address - Phone:215-438-5799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006314B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily