Provider Demographics
NPI:1811378565
Name:NEWKIRK, CANDACE (AUD)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3810
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-3810
Mailing Address - Country:US
Mailing Address - Phone:417-347-3746
Mailing Address - Fax:417-347-6769
Practice Address - Street 1:1331 W 32ND ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1601
Practice Address - Country:US
Practice Address - Phone:417-347-3746
Practice Address - Fax:417-347-6769
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020035494231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist