Candice Renee Douglas, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2025029778 Issued in MO

Practice address

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098

Phone

(573) 596-0456

NPI assigned

Jul 17, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1164314738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 JARED ST",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655833452",
            "telephone_number": "573-596-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CANDICE",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025029778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brock Justin Dodsworth, PTA
• Jessica Dolan, RDN
• Justin Marshall Dominguez, DPT
• Maria Mercedes Dominguez, PHD, LMFT
• Crystal Le-Ann Dornbach-Poojari, PHARM. D.
• Derek Bradley Douglas, D.O.
• Patrick Lee Downing Jr., RDN
• Zaine Robert Dugan
• Stephen Lindsey Dunaway, LCSW
• Braxton Stanley Duncan, DDS

• Family Nurse Practitioner in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.