Provider Demographics
NPI:1447938949
Name:KOCKE, CANDACE MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:MICHELLE
Last Name:KOCKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 HAMPTON KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-9161
Mailing Address - Country:US
Mailing Address - Phone:501-286-9797
Mailing Address - Fax:
Practice Address - Street 1:200 E INNOVATION WAY
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44316-0001
Practice Address - Country:US
Practice Address - Phone:501-286-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR222025163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health