Provider Demographics
NPI:1306000104
Name:STEARNS, CANDACE RAE (RN)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:RAE
Last Name:STEARNS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ECKLES ST
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:MO
Mailing Address - Zip Code:63957-1012
Mailing Address - Country:US
Mailing Address - Phone:573-223-4689
Mailing Address - Fax:
Practice Address - Street 1:220 ECKLES ST
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:MO
Practice Address - Zip Code:63957-1012
Practice Address - Country:US
Practice Address - Phone:573-223-4689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO118743163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management