Provider Demographics
NPI:1174851356
Name:CAPUTO, CANDACE M (RN, CDE)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:M
Last Name:CAPUTO
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SOUTH STREET
Mailing Address - Street 2:HARRINGTON HOSPITAL
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550
Mailing Address - Country:US
Mailing Address - Phone:508-765-2294
Mailing Address - Fax:508-764-2475
Practice Address - Street 1:100 SOUTH ST
Practice Address - Street 2:HARRINGTON HOSPITAL
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-4051
Practice Address - Country:US
Practice Address - Phone:508-765-2294
Practice Address - Fax:508-764-2475
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223997163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA223997OtherREGISTERED NURSE
MA2071-0344OtherCERTIFIED DIABETES EDUCATOR