NPIMap

Organization Active NPI

Candace M Funderburk

  • Certified Registered Nurse Anesthetist
  • Florien, LA
National Provider Identifier
1003201211
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
074290 Issued in LA
Legal business name
CANDACE M FUNDERBURK
Practice address
881 Dess Rd
Florien, LA 71429-4267
Phone
(318) 508-2009
NPI assigned
Apr 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Candace M Funderburk, CRNANPI 1003047804
Title
Owner
Phone
(318) 508-2009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 074290 LA Primary

Addresses

Primary practice location

881 Dess Rd
Florien, LA 71429-4267

Mailing address

881 Dess Rd
Florien, LA 71429-4267

National Provider Directory

National Provider Directory

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1003201211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 DESS RD",
            "city": "FLORIEN",
            "state": "LA",
            "postal_code": "714294267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 DESS RD",
            "city": "FLORIEN",
            "state": "LA",
            "postal_code": "714294267",
            "telephone_number": "318-508-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDACE M FUNDERBURK",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "FUNDERBURK",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-508-2009",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "074290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florien, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.