Provider Demographics
NPI:1770864902
Name:GERMAN, CANDY ROSE (TARGET CASE MANAGER)
Entity Type:Individual
Prefix:MRS
First Name:CANDY
Middle Name:ROSE
Last Name:GERMAN
Suffix:
Gender:F
Credentials:TARGET CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 MASSACHUSETT AVE
Mailing Address - Street 2:
Mailing Address - City:KINSLEY
Mailing Address - State:KS
Mailing Address - Zip Code:67547
Mailing Address - Country:US
Mailing Address - Phone:620-659-5147
Mailing Address - Fax:620-659-2483
Practice Address - Street 1:406 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:KINSLEY
Practice Address - State:KS
Practice Address - Zip Code:67547-1055
Practice Address - Country:US
Practice Address - Phone:620-659-5147
Practice Address - Fax:620-659-2483
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator