Provider Demographics
NPI:1710649397
Name:SADLER, CANDY RAYE
Entity Type:Individual
Prefix:
First Name:CANDY
Middle Name:RAYE
Last Name:SADLER
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 1:74 PIERCE ST APT F
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-4475
Mailing Address - Country:US
Mailing Address - Phone:681-285-1448
Mailing Address - Fax:
Practice Address - Street 1:74 PIERCE ST APT F
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-4475
Practice Address - Country:US
Practice Address - Phone:681-285-1448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant