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General NPI Number Information
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NPI Number | 1790663649
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Entity Type | Individual
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Provider Name | CANDICE STITMAN
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Gender | Female
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 3655 KIPLING AVE
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City | MEMPHIS
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State | TN
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Zip | 38128-2049
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Country | US
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Telephone | 901-486-8164
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Fax |
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Provider Business Mailing Address
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Address Line | 4296 DAVIDCREST DR
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City | MEMPHIS
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State | TN
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Zip | 38128-1704
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Country | US
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Telephone | 901-486-8164
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 0000004233
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | 0000004233
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License Number State | TN
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