Provider Demographics
NPI:1720835242
Name:CALDWELL, MARCELLA
Entity type:Individual
Prefix:MRS
First Name:MARCELLA
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARCELLA
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:208 BUCKINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:TX
Mailing Address - Zip Code:76643-4203
Mailing Address - Country:US
Mailing Address - Phone:254-424-7232
Mailing Address - Fax:
Practice Address - Street 1:208 BUCKINGHAM PL
Practice Address - Street 2:
Practice Address - City:HEWITT
Practice Address - State:TX
Practice Address - Zip Code:76643-4203
Practice Address - Country:US
Practice Address - Phone:254-424-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX950767163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse