Individual
CANDICE RENEE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0456
Mailing address
129 JARED ST, WAYNESVILLE, MO 65583-3452
(573) 596-0456
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025029778
MO
Other
Enumeration date
07/17/2025
Last updated
12/30/2025
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