Provider Demographics
NPI:1407529878
Name:SCARPA, CANDICE M (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:M
Last Name:SCARPA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 GLADDEN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-2236
Mailing Address - Country:US
Mailing Address - Phone:870-741-0016
Mailing Address - Fax:
Practice Address - Street 1:1417 GLADDEN ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2236
Practice Address - Country:US
Practice Address - Phone:870-741-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2023-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR217125363LF0000X
ARR097647363LF0000X
MO2023030278363LF0000X
MO2023030484363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily