DR. CANDACE MALSON (NPI# 1205815461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205815461 |
| Entity Type | Individual |
| Full Name | DR. CANDACE MALSON |
| Credential | NP |
| Practice Address |
156 Missouri Blvd Ste B Gravois Mills MO 65037-5394 |
| Mailing Address |
1500 N Westwood Blvd Poplar Bluff MO 63901-3318 |
| Practice Telephone | 5733745263 |
| Practice Fax Number | 5733744933 |
| Mailing Telephone | 5736864151 |
| Enumeration Date | 2006-01-15 |
| Last Update Date | 2019-02-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2019004014 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP2225 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
156 MISSOURI BLVD STE B |
| City | GRAVOIS MILLS |
| State | MO |
| Zip Code | 65037-5394 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124023940 | Kenneth L Derrington | Family Medicine | 156 Missouri Blvd Ste B, Gravois Mills, MO 65037-5394 | 2005-06-17 |
| 1619321817 | Anton Kosov | Internal Medicine | 156 Missouri Blvd Ste B, Gravois Mills, MO 65037-5394 | 2016-04-14 |
| 1932203262 | Kimberly Collins | Nurse Practitioner | 156 Missouri Blvd Ste B, Gravois Mills, MO 65037-5394 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902384993 | Show-me Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 31358 Aqua Vita Rd, Gravois Mills, MO 65037 | 2018-08-01 |
| 1871778977 | Laurie Family Eyecare, Inc. | Optometrist | 138 S. Main, Suite C, Laurie, MO 65037 | 2008-01-08 |
| 1770635880 | Irene Toth | Pharmacist | 29530 Royal Oak Ln, Gravois Mills, MO 65037-4325 | 2007-01-17 |
| 1942323738 | Jamaica Cottage Isl II | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 31360 Aqua Vita Rd, Gravois Mills, MO 65037-4762 | 2007-04-09 |
| 1487785341 | Jamaica Cottage II, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 31360 Aqua Vita Rd, Gravois Mills, MO 65037-4803 | 2007-03-09 |
| 1811103773 | Bristol Care, Inc. | Assisted Living Facility | 299 Highway Ra, Laurie, MO 65037-6024 | 2007-05-15 |
| 1609915958 | Kelly Grace Gramke | Specialist | 401 N Main St, Laurie, MO 65037-6173 | 2007-02-05 |
| 1750387098 | C. Edward Caldwell | Podiatrist | 138 S Main St, Ste A, Laurie, MO 65037-6196 | 2005-06-22 |
| 1508303264 | Elizabeth Barrett | Acupuncturist | 118 S Main St, Gravois Mills, MO 65037-6196 | 2017-01-19 |
| 1235492539 | Daniel James Cerra | Pharmacist | 154 S Main St, Gravois Mills, MO 65037-6196 | 2012-06-21 |
| Find all providers in zip 65037 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619285 | Jennifer Lee Speiser | Nurse Practitioner | 12545 Olive Blvd, Saint Louis, MO 63141-6311 | 2020-11-04 |
| 1215537220 | John Franklin Niswonger | Nurse Practitioner | 861 Canyon Trl, Jackson, MO 63755-4001 | 2020-10-28 |
| 1972119014 | Michael Christopher Hassert | Nurse Practitioner | 2290 Graystone Dr, Saint Charles, MO 63303-5159 | 2020-09-22 |
| 1265045264 | Andrea Jane Montgomery | Nurse Practitioner | 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 | 2020-08-28 |
| 1710596424 | Clay Thornburg | Nurse Practitioner | 602 S Home St, Palmyra, MO 63461-1747 | 2020-07-28 |
| 1396362224 | Erin M Kehoe | Nurse Practitioner | 12973 Olive Blvd, Saint Louis, MO 63141-6149 | 2020-06-26 |
| 1508482506 | Matthew Dale Tieskoetter | Nurse Practitioner | 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 | 2020-06-25 |
| 1497391924 | Stephnie Michelle Wriedt | Nurse Practitioner | 1605 E Broadway Ste 250, Columbia, MO 65201-8031 | 2019-11-19 |
| 1861033615 | Benedicta Esi | Nurse Practitioner | 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 | 2019-10-02 |
| 1245896893 | Katina D Smith | Nurse Practitioner | 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 | 2019-05-18 |
| Find all providers with the same taxonomy | ||||
| City | GRAVOIS MILLS |
| Zip Code | 65037 |
Please comment or provide details below to improve the information on DR. CANDACE MALSON.
| 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.