Provider Demographics
NPI:1538208046
Name:CALAMOS, LAURA LYNNE (PHD, FNP-BC, RN)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LYNNE
Last Name:CALAMOS
Suffix:
Gender:F
Credentials:PHD, FNP-BC, RN
Other - Prefix:PROF
Other - First Name:LAURA
Other - Middle Name:CALAMOS
Other - Last Name:NASIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:350 N MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1635
Mailing Address - Country:US
Mailing Address - Phone:734-433-1500
Mailing Address - Fax:734-433-1400
Practice Address - Street 1:350 N MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1635
Practice Address - Country:US
Practice Address - Phone:734-433-1500
Practice Address - Fax:734-433-1400
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704352432363LF0000X
NC201581363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704352432OtherREGISTERED NURSE LICENSE AND SPECIALTY CERTIFICATION
MI4704352432OtherREGISTERED NURSE LICENSE AND SPECIALTY CERTIFICATION
NCP69307Medicare UPIN