Provider Demographics
NPI:1073356036
Name:LEDFORD, CANDI JO (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CANDI
Middle Name:JO
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CANDI
Other - Middle Name:JO
Other - Last Name:HANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9820 METCALF AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-6188
Mailing Address - Country:US
Mailing Address - Phone:913-217-7244
Mailing Address - Fax:913-218-0904
Practice Address - Street 1:9820 METCALF AVE STE 110
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-6188
Practice Address - Country:US
Practice Address - Phone:913-217-7244
Practice Address - Fax:913-218-0904
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024018524207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine