Provider Demographics
NPI:1376037796
Name:FRANTZ, CANDACE ROSE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:ROSE
Last Name:FRANTZ
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 1:6793 SW GROUNDHOG RD
Mailing Address - Street 2:
Mailing Address - City:CROOKED RIVER RANCH
Mailing Address - State:OR
Mailing Address - Zip Code:97760-7616
Mailing Address - Country:US
Mailing Address - Phone:541-279-1062
Mailing Address - Fax:
Practice Address - Street 1:1251 NE BEAN WAY
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-8955
Practice Address - Country:US
Practice Address - Phone:541-777-7744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201390744RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse