Healthcare Provider Details

I. General information

NPI: 1619972882
Provider Name (Legal Business Name): CANDEE S ADAMS ARNP, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 E HARRY ST
WICHITA KS
67218-3713
US

IV. Provider business mailing address

PO BOX 1897
WICHITA KS
67201-1897
US

V. Phone/Fax

Practice location:
  • Phone: 316-689-5475
  • Fax: 316-691-6772
Mailing address:
  • Phone: 316-268-8131
  • Fax: 316-291-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number112129
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number44895
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: