Provider Demographics
NPI:1992223648
Name:THOMPSON, CANDACE NOEL
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:NOEL
Last Name:THOMPSON
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 1:10842 MCGEE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-5018
Mailing Address - Country:US
Mailing Address - Phone:816-708-0540
Mailing Address - Fax:913-273-0588
Practice Address - Street 1:10842 MCGEE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5018
Practice Address - Country:US
Practice Address - Phone:816-708-0540
Practice Address - Fax:913-273-0588
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator