Provider Demographics
NPI:1295517191
Name:RAWLS, CANDACE LATEIA (LVN)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:LATEIA
Last Name:RAWLS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 S CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4070
Mailing Address - Country:US
Mailing Address - Phone:945-218-5693
Mailing Address - Fax:
Practice Address - Street 1:2150 S CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4070
Practice Address - Country:US
Practice Address - Phone:945-218-5693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352976164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse