Provider Demographics
NPI:1538305230
Name:NEWMAN, CANDICE E
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:E
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6558 W REMUS RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-9624
Mailing Address - Country:US
Mailing Address - Phone:989-621-7477
Mailing Address - Fax:
Practice Address - Street 1:6558 W REMUS RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-9624
Practice Address - Country:US
Practice Address - Phone:989-621-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist