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NPI Code Detail

MEDICARE: MS. CANDICE S MIDDLETON

MEDICARE: MS. CANDICE S MIDDLETON
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
1164W00000XLicensed Practical NurseP44995SC

General Provider Information

NPI Number : 1134930183
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CANDICE S MIDDLETON
Provider Business Mailing Address
First Line : 135 BRIGHT MEADOW RD
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-4510
Country : US
Telephone Number : 470-439-9309
Fax Number :
Provider Business Practice Location Address
First Line : 8570 RIVERS AVE
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9892
Country : US
Telephone Number : 470-439-9039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2025
Last Update Date : 01/17/2025

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Directions to “ MS. CANDICE S MIDDLETON ” Practice Location

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