Provider Demographics
NPI:1831822394
Name:ESCOE, KANDICE CHAMAYN (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:KANDICE
Middle Name:CHAMAYN
Last Name:ESCOE
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17610 EGO AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3170
Mailing Address - Country:US
Mailing Address - Phone:313-680-5707
Mailing Address - Fax:
Practice Address - Street 1:3950 BEAUBIEN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2166
Practice Address - Country:US
Practice Address - Phone:313-832-8433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704319220163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty