Healthcare Provider Details

I. General information

NPI: 1437812500
Provider Name (Legal Business Name): KANDICE MCALPINE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 AERO DR
MASON OH
45040-8818
US

IV. Provider business mailing address

3992 CRESTVIEW DR
LOVELAND OH
45140-1019
US

V. Phone/Fax

Practice location:
  • Phone: 513-770-4122
  • Fax:
Mailing address:
  • Phone: 513-939-5353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.006953RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number4749
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: