Individual
CANDACE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3525
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 875-3000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021051164
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420107685
—
MO
Enumeration date
02/07/2022
Last updated
04/15/2022
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