Individual
CANDIS M TOOTHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
597 LIBERT STREET, SUITE 15, WEST MILFORD, WV 26451
(304) 745-4568
(304) 326-3700
Mailing address
597 LIBERTY STREET, WEST MILFORD, WV 26451
(304) 745-4568
(304) 326-3700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
73558
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02045680000
—
WV
01
—
CH6378
RR MEDICARE
WV
Enumeration date
10/23/2014
Last updated
08/19/2015
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