Individual
CANDACE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2411 HOLMES ST, KANSAS CITY, MO 64108-2741
(816) 645-2919
Mailing address
7722 N NORTON AVE, KANSAS CITY, MO 64119-5464
(816) 645-2919
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2020027400
MO
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/24/2019
Last updated
08/31/2020
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