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NPI Code Detail

MEDICARE: CANDY KATHLEEN O'CONNELL M.A.,CCC-A

MEDICARE: CANDY KATHLEEN O'CONNELL M.A.,CCC-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237600000XAudiologist-Hearing Aid Fitter263CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CF8286OTHERCORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134390719
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDY KATHLEEN O'CONNELL M.A.,CCC-A
Provider Business Mailing Address
First Line : 7850 VANCE DR STE 225
Second Line :
City : ARVADA
State : CO
Zip : 80003-2133
Country : US
Telephone Number : 303-431-8881
Fax Number : 303-431-8564
Provider Business Practice Location Address
First Line : 7850 VANCE DR STE 225
Second Line :
City : ARVADA
State : CO
Zip : 80003-2133
Country : US
Telephone Number : 303-431-8881
Fax Number : 303-431-8564
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2008
Last Update Date : 10/30/2008

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