Candice Christina McKinnon, C.N.A

Primary specialty

Respite CareTaxonomy code 385H00000X

License

401722 Issued in AK

Practice address

17250 Palos Verdes Dr
Eagle River, AK 99577-8133

Phone

(907) 696-4433

NPI assigned

Mar 8, 2007

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 1

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225169543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 773575",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995773575",
            "telephone_number": "907-696-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17250 PALOS VERDES DR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778133",
            "telephone_number": "907-696-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "CANDICE",
        "middle_name": "CHRISTINA",
        "name_prefix": "Mrs.",
        "credential": "C.N.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AK",
            "license": "401722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC7062",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah McElroy
• Christina McGauthiar, LCSW, CDC I
• Marci Ann McGill, RD, LD
• Kiana Clarey McGovern
• Kirsten Elaine McKenzie
• Heather Ann McLain, DPT
• Sam McMichael
• Ashlyn McVey
• Tracie Meaders, LPC
• Meadow Creek Healthcare LLC (Meadow Creek Dermatology)

• Respite Care in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Respite Care in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.