Candice Harrison, PHLEBOTOMIST

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

Q5D2FT3 Issued in LA

Practice address

316 S Gum St
Minden, LA 71055-5226

Phone

(318) 505-9452

NPI assigned

Jan 9, 2023

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

Electronic endpoints 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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1457065161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S GUM ST",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710555226",
            "telephone_number": "318-505-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S GUM ST",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710555226",
            "telephone_number": "318-505-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "CANDICE",
        "credential": "PHLEBOTOMIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "LA",
            "license": "Q5D2FT3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "10217688",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "3185059452",
            "affiliation": "N",
            "endpointDescription": "phone",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "316 S Gum St",
            "city": "Minden",
            "state": "LA",
            "country_code": "US",
            "postal_code": "710555226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andre Hampton
• Hand in Hand Hospice Care LLC
• Ladonna J Harrell, NP
• Gracie E Harris, RDH
• Mary L Harris
• Sheretha Harrison
• Brenda Hawkins, NP
• Shykiia Hawkins
• Triveya Shanell Hawkins
• Marsha Laffitte Hayes, MS, LPC

• Community Health Worker in Minden, LA
• Providers in Minden, LA by specialty
• Community Health Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.