Organization
WOUND OSTOMY LEG & FOOT CARE CLINIC AND SPA LLC
Active
Organization
WOUND OSTOMY LEG & FOOT CARE CLINIC AND SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE LATRELLE LEWIS DNP, FNP-C (FAMILY NURSE PRACTITIONER)
(913) 547-3494
Entity
Organization
Contact information
Practice address
9808 E 66TH TER, RAYTOWN, MO 64133-5850
(913) 547-3494
(833) 970-2362
Mailing address
2005 MARJORIE CIR, LEAVENWORTH, KS 66048-2135
(913) 547-3494
(833) 970-2362
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
—
—
163WX1500X
Ostomy Care Registered Nurse
—
—
Other
Enumeration date
04/07/2026
Last updated
04/30/2026
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