Provider Demographics
NPI:1154435857
Name:SCHUIERER, CANDACE P (PA)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:P
Last Name:SCHUIERER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1739 E BEVERLY AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3593
Mailing Address - Country:US
Mailing Address - Phone:928-681-8734
Mailing Address - Fax:928-263-4794
Practice Address - Street 1:706 THE RIALTO
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-3524
Practice Address - Country:US
Practice Address - Phone:941-484-8004
Practice Address - Fax:941-484-8869
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
FLPA9102281363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1421XOtherRAILROAD MEDICARE
FL011926100Medicaid
FLU1421XMedicare PIN