Provider Demographics
NPI:1447263793
Name:RINEHART, CANDY SUE
Entity type:Individual
Prefix:
First Name:CANDY
Middle Name:SUE
Last Name:RINEHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1492 E BROAD ST
Mailing Address - Street 2:STE 1203
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1546
Mailing Address - Country:US
Mailing Address - Phone:614-685-9994
Mailing Address - Fax:614-685-9993
Practice Address - Street 1:1492 E BROAD ST
Practice Address - Street 2:STE 1203
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1546
Practice Address - Country:US
Practice Address - Phone:614-685-9994
Practice Address - Fax:614-685-9993
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN173657363LF0000X
OHCOA03610NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2046593Medicaid
OH2046593Medicaid
OHS65542Medicare UPIN