National Provider Identifier Database

CANDICE B BURNSIDE, APRN – NPI #1013320373
Family


Contact Information

CANDICE B BURNSIDE, APRN
225 E JACKSON AVE
JONESBORO, AR72401-3119
Phone: 870-207-1630
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for CANDICE B BURNSIDE

NPI Number 1013320373
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 06/04/2014
Last updated 05/07/2015 - About 11 years ago
Sole proprietor1 No
Identifiers
  • AR License #: A004095
  • AR Medicaid: 204689758
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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