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NPI Code Detail

MEDICARE: MRS. CANDACE DAUBERT CNA

MEDICARE: MRS. CANDACE DAUBERT CNA
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
1376K00000XNurse's Aide9602620PA

General Provider Information

NPI Number : 1710003991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CANDACE DAUBERT CNA
Provider Business Mailing Address
First Line : 104 VAUX AVE
Second Line :
City : TREMONT
State : PA
Zip : 17981-1418
Country : US
Telephone Number : 570-695-1042
Fax Number :
Provider Business Practice Location Address
First Line : 2250 HICKORY RD
Second Line :
City : PLYMOUTH MEETING
State : PA
Zip : 19462-1047
Country : US
Telephone Number : 610-834-1122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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