MEDICARE: CANDACE MIZE FNP

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
1	363LF0000X	Family Nurse Practitioner	2026004192	MO
2	363LF0000X	Family Nurse Practitioner	236279	AR

General Provider Information

NPI Number	:	1922957489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDACE MIZE FNP

Provider Business Mailing Address
First Line	:	1050 W 10TH ST
Second Line	:
City	:	ROLLA
State	:	MO
Zip	:	65401-2905
Country	:	US
Telephone Number	:	573-458-8899
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 STATE HIGHWAY 248
Second Line	:
City	:	BRANSON
State	:	MO
Zip	:	65616-3721
Country	:	US
Telephone Number	:	417-553-1197
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	05/13/2026

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Directions to “ CANDACE MIZE FNP” Practice Location

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