CANDICE LAUREN RAYNOR NP
NPI 1134481104
Nurse Practitioner in South Lake Tahoe, CA

Q: What is Candice Raynor's NPI number?

The NPI number for Candice Raynor is 1134481104. It was assigned to this individual provider in the NPPES registry on June 14, 2012.

Q: What is Candice Raynor's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Candice Raynor was last updated on July 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 14, 2012

2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150(530) 543-5497(530) 541-8683 Get Directions Write a Review

NPPES record last updated: July 16, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Candice Lauren Raynor Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANDICE LAUREN RAYNOR NP (NPI 1134481104) is an individual nurse practitioner in South Lake Tahoe, California, licensed in California (21581) and active in the NPI registry since June 2012.

NPPES Registry Identity

NPI1134481104

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameCANDICE LAUREN RAYNORCredential: NP

Location Address2170 SOUTH AVESouth Lake Tahoe, CA 96150-7026

Mailing Address1111 Emerald Bay RdSouth Lake Tahoe, CA 96150-6207 · (530) 543-5659 · Fax (530) 541-8723

Phone(530) 543-5497

Fax(530) 541-8683

Sole ProprietorNo

Enumeration DateJune 14, 2012

Last NPPES UpdateJuly 16, 2014

✔ NPI 1134481104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · 21581

Definition

(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 with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2170 SOUTH AVE, South Lake Tahoe, CA 96150

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BARTON HEALTHCARE SYSTEM

General Acute Care Hospital