Provider Demographics
NPI:1457149593
Name:BARR, CANDICE M
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:M
Last Name:BARR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 745
Mailing Address - Street 2:
Mailing Address - City:DELLSLOW
Mailing Address - State:WV
Mailing Address - Zip Code:26531-0745
Mailing Address - Country:US
Mailing Address - Phone:304-292-6880
Mailing Address - Fax:
Practice Address - Street 1:219 HARTMAN RUN RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-5377
Practice Address - Country:US
Practice Address - Phone:304-292-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant