Kornnisa Mccallon, FNP is a
Nurse Practitioner - Family physician based in Apple Valley, California. Kornnisa Mccallon is licensed to practice in California (license number 95023549) and her current practice location is 16167 Siskiyou Rd Ste A, Apple Valley, California. She can be reached at her office (for appointments etc.) via phone at
(760) 242-2146.
NPI number for Kornnisa Mccallon is 1861182115 and her current mailing address is Po Box 1032, Helendale, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1861182115.
Physician's Profile
Full Name | Kornnisa Mccallon |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 16167 Siskiyou Rd Ste A, Apple Valley, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1861182115
- Provider Enumeration Date: 05/10/2023
- Last Update Date: 03/14/2025
Medical Identifiers
Medical identifiers for Kornnisa Mccallon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1861182115 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207VX0201X | Obstetrics & Gynecology - Gynecologic Oncology | 95023549 (California) | Secondary |
363LP2300X | Nurse Practitioner - Primary Care | 95023549 (California) | Secondary |
363LF0000X | Nurse Practitioner - Family | 95023549 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kornnisa Mccallon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kornnisa Mccallon, FNP Po Box 1032, Helendale, CA 92342-1032 Ph: (442) 319-9630 | Kornnisa Mccallon, FNP 16167 Siskiyou Rd Ste A, Apple Valley, CA 92307-0837 Ph: (760) 242-2146 |
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