Individual
CANDACE C. CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
330 LONGWOOD DR, GRENADA, MS 38901-9326
(662) 226-1012
Mailing address
330 LONGWOOD DR, GRENADA, MS 38901-9326
(662) 226-1012
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P316109
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770519
—
MS
Enumeration date
12/12/2006
Last updated
07/09/2007
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