Individual provider · Type 1 NPI

Kornnisa McCallon, FNP

Family Nurse Practitioner · Apple Valley, CA

NPI number 1861182115 Active

Practice location

16167 Siskiyou Rd Ste A
Apple Valley, CA 92307-0837

Call (760) 242-2146 Map

Mailing address

PO Box 1032
Helendale, CA 92342-1032

Specialties and licenses

TaxonomyCodeLicense
Gynecologic Oncology Physician 207VX0201X95023549 (CA)
Primary Care Nurse Practitioner 363LP2300X95023549 (CA)
Family Nurse Practitioner Primary 363LF0000X95023549 (CA)

Family Nurse Practitioner: Definition to come...

2 other providers at this address

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About NPI 1861182115

Kornnisa McCallon, FNP's National Provider Identifier is 1861182115, issued on May 10, 2023. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Apple Valley, CA. The record was last updated on Mar 14, 2025.