MS. CANDICE WHITE (NPI# 1104272079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104272079 |
| Entity Type | Individual |
| Full Name | MS. CANDICE WHITE |
| Credential | APN |
| Practice Address |
530 Ne Glen Oak Ave Peoria IL 61637-0001 |
| Mailing Address |
205 E 4th St Mackinaw IL 61755-7577 |
| Practice Telephone | 3096552000 |
| Mailing Telephone | 3096486632 |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SC0200X |
Clinical Nurse Specialist Specialization: Critical Care Medicine |
209014209 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871842898 | Candice Brooke White | Pharmacist | 3901 N Kings Hwy, Myrtle Beach, SC 29577-2736 | 2012-09-05 |
| 1184870073 | Candice N White | Physician Assistant | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2008-08-12 |
| Street Address |
530 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61637-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346235777 | Jack Michael Gibson | Obstetrics & Gynecology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-09-12 |
| 1053912188 | Janie Clary | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-11-04 |
| 1265030548 | Christina David | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-10-09 |
| 1033726831 | Corry Lynn Rediger | Occupational Therapist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-25 |
| 1720694094 | Katelynn M Madden | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-21 |
| 1568074474 | Amanda Diane Beoletto | Pharmacist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-08-21 |
| 1881212892 | Mohammad Mousbah Al-tabbaa | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1750909693 | Mohammad Gareeb | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1376160846 | Bassel Elia Abouzeid | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2020-07-01 |
| 1700403516 | Christina Marie Spurgeon | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| 1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
| 1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
| 1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
| 1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
| Find all providers in zip 61637 | ||||
| Taxonomy Code | 364SC0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Critical Care Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316153984 | Constance A Wright | Clinical Nurse Specialist | 5758 South Maryland, Chicago, IL 60637 | 2007-05-14 |
| 1215076153 | Elizabeth (beth) T Zimmermann | Clinical Nurse Specialist | 5839 So. Maryland Ave., Mc4062-ucch, Chicago, IL 60637 | 2007-02-06 |
| 1205332509 | Irene Copak | Clinical Nurse Specialist | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2018-04-04 |
| 1831623636 | Sheri Moonan | Clinical Nurse Specialist | 4440 W 95th St, 6324p- Lung Transplant Office, Oak Lawn, IL 60453-2600 | 2017-04-18 |
| 1982029856 | Jennifer Casey | Clinical Nurse Specialist | 1120 N Melvin St, Gibson City, IL 60936-1477 | 2014-02-28 |
| 1336578582 | Pamela Heydorn | Clinical Nurse Specialist | 133 E Brush Hill Rd, Ste. 202, Elmhurst, IL 60126-5659 | 2013-11-08 |
| 1073956777 | Leslie Ann Collins | Clinical Nurse Specialist | 800 W Central Rd, Arlington Heights, IL 60005-2349 | 2013-04-11 |
| 1841539616 | Darla Jo Bradle | Clinical Nurse Specialist | 2222 E State St, Suite 209, Rockford, IL 61104-1573 | 2013-02-13 |
| 1306183173 | Ann L Miller | Clinical Nurse Specialist | 12251 S 80th Ave, Palos Heights, IL 60463-1256 | 2013-01-13 |
| 1831444082 | Ann Czarny | Clinical Nurse Specialist | 5101 Willow Springs Rd, La Grange, IL 60525-2600 | 2012-07-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.