Candice Lee McIntyre, RN

Individual provider Active NPI General Practice Registered Nurse · Mexico, NY

NPI 1669036166 · NPPES record last updated Apr 30, 2019

Key facts

NPI
1669036166
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
606474 (NY)
Practice address
4084 State Route 69
Mexico, NY 13114-3380
Phone
(315) 806-7268
NPI assigned
Apr 30, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
606474NYMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 606474 NY Yes

Addresses

Primary practice location

4084 State Route 69
Mexico, NY 13114-3380

Mailing address

4084 State Route 69
Mexico, NY 13114-3380
Phone (315) 806-7268

Other providers in Mexico, NY

All providers in Mexico, NY · General Practice Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.