Individual provider · Type 1 NPI

Candice Lauren Raynor, NP

Nurse Practitioner · South Lake Tahoe, CA

NPI number 1134481104 Active

Practice location

2170 South Ave
South Lake Tahoe, CA 96150-7026

Call (530) 543-5497 Map

Fax (530) 541-8683

Mailing address

1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X21581 (CA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1134481104

Candice Lauren Raynor, NP's National Provider Identifier is 1134481104, issued on Jun 14, 2012. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in South Lake Tahoe, CA. The record was last updated on Jul 16, 2014.