Provider Demographics
NPI:1740929314
Name:CALKINS, ALEXANDER (MSN, NP, AGACNP-BC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:CALKINS
Suffix:
Gender:M
Credentials:MSN, NP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 N MEDICAL CENTER DR W STE 223
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6885
Mailing Address - Country:US
Mailing Address - Phone:559-449-9990
Mailing Address - Fax:
Practice Address - Street 1:729 N MEDICAL CENTER DR W STE 223
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6885
Practice Address - Country:US
Practice Address - Phone:559-449-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020713363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty