Candice Ezard

Individual provider Active NPI Licensed Practical Nurse · Dansville, NY

NPI 1457086514 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1457086514
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
316138-01 (NY)
Practice address
45 Maple St
Dansville, NY 14437-9182
Phone
(585) 335-5052
NPI assigned
Jul 21, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
316138-01NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Casa-Trinity, Inc. Past
since Jul 24, 2022
Accepting new patients
Casa-Trinity, Inc. Past
since Jul 24, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 316138-01 NY Yes

Addresses

Primary practice location

45 Maple St
Dansville, NY 14437-9182

Mailing address

5018 Egypt Rd
Canandaigua, NY 14424-9317

Other identifiers

IdentifierTypeStateIssuer
161039939OtherNYALL OTHER INSURANCES
161039939MedicaidNY

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address cezard@casa-trinity.org Direct

Other providers in Dansville, NY

All providers in Dansville, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.