Provider Demographics
NPI:1144628298
Name:CALHOUN-VASKO, AMY (APN,CNM)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CALHOUN-VASKO
Suffix:
Gender:F
Credentials:APN,CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16131
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4056
Mailing Address - Country:US
Mailing Address - Phone:919-322-0173
Mailing Address - Fax:919-977-9344
Practice Address - Street 1:905 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SHATTUCK
Practice Address - State:OK
Practice Address - Zip Code:73858-9208
Practice Address - Country:US
Practice Address - Phone:734-552-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC667367A00000X
4704260721367A00000X
OK212295367A00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife