Individual provider Active NPI

Candice Eyre, LPN

  • Licensed Practical Nurse
  • Sedro Woolley, WA
National Provider Identifier
1578007290
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP00058374 Issued in WA
Practice address
701 Greenstreet Blvd
Sedro-Woolley, WA 98284-3217
Phone
(360) 333-9678
Fax
(360) 757-7749
NPI assigned
Dec 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP00058374 WA Primary

Addresses

Primary practice location

701 Greenstreet Blvd
Sedro-Woolley, WA 98284-3217

Mailing address

701 Greenstreet Blvd
Sedro Woolley, WA 98284-1327
Phone (360) 333-9678

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP00058374WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1578007290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 GREENSTREET BLVD",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982841327",
            "telephone_number": "360-333-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GREENSTREET BLVD",
            "city": "SEDRO-WOOLLEY",
            "state": "WA",
            "postal_code": "982843217",
            "telephone_number": "360-333-9678",
            "fax_number": "360-757-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYRE",
        "first_name": "CANDICE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00058374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedro Woolley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.