Provider Demographics
NPI:1265175145
Name:STUDYMINE, CANDI
Entity type:Individual
Prefix:
First Name:CANDI
Middle Name:
Last Name:STUDYMINE
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 1:18 LINNEA LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHILI
Mailing Address - State:NY
Mailing Address - Zip Code:14514-9724
Mailing Address - Country:US
Mailing Address - Phone:585-690-5399
Mailing Address - Fax:
Practice Address - Street 1:18 LINNEA LN
Practice Address - Street 2:
Practice Address - City:NORTH CHILI
Practice Address - State:NY
Practice Address - Zip Code:14514-9724
Practice Address - Country:US
Practice Address - Phone:585-690-5399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343221164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse