Provider Demographics
NPI:1841155108
Name:WALTERS, KANDYCE RENEE
Entity type:Individual
Prefix:
First Name:KANDYCE
Middle Name:RENEE
Last Name:WALTERS
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 1:1307 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-2637
Mailing Address - Country:US
Mailing Address - Phone:308-221-0021
Mailing Address - Fax:
Practice Address - Street 1:1307 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-2637
Practice Address - Country:US
Practice Address - Phone:308-221-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-18
Last Update Date:2025-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant