Healthcare Provider Details

I. General information

NPI: 1740935378
Provider Name (Legal Business Name): TANYA LYNN CANDEE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 03/11/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 2ND AVE SW
SIDNEY MT
59270-4020
US

IV. Provider business mailing address

35298 COUNTY ROAD 131
FAIRVIEW MT
59221-9446
US

V. Phone/Fax

Practice location:
  • Phone: 406-290-8727
  • Fax:
Mailing address:
  • Phone: 701-260-1847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNUR-RN-LIC-47908
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: