Provider Demographics
NPI:1437105020
Name:TEMPERLY, CANDY JO (PA)
Entity Type:Individual
Prefix:
First Name:CANDY
Middle Name:JO
Last Name:TEMPERLY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CANDY
Other - Middle Name:JO
Other - Last Name:DROESZLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1500 ASSOCIATES DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2201
Mailing Address - Country:US
Mailing Address - Phone:563-584-4100
Mailing Address - Fax:563-584-4110
Practice Address - Street 1:1240 BIG JACK RD
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-8902
Practice Address - Country:US
Practice Address - Phone:608-348-6266
Practice Address - Fax:608-342-5600
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1856-023363A00000X
IA001691363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI006424005Medicare ID - Type Unspecified
Q51687Medicare UPIN