DR. CANDACE-RAE DIANA HAISLIP (NPI# 1588213532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588213532 |
| Entity Type | Individual |
| Full Name | DR. CANDACE-RAE DIANA HAISLIP |
| Credential | DNP, RN, CPNP-PC |
| Practice Address |
1 Childrens Pl Saint Louis MO 63110-1002 |
| Mailing Address |
5830 Nottingham Ave Apt 2e Saint Louis MO 63109-2732 |
| Practice Telephone | 3144546000 |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2019-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
2013035101 | MO | Nursing Service Providers |
| Y | 363LP0222X |
Nurse Practitioner Specialization: Pediatrics, Critical Care |
2013035101 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 CHILDRENS PL |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476495 | William Lee Johnson | Pediatrics | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2005-06-09 |
| 1114527033 | Kristin Kueper | Dietitian, Registered | 1 Childrens Pl, Saint Louis, MO 63110-1081 | 2020-10-29 |
| 1609474055 | Courtney Tompkins | Audiologist | 1 Childrens Pl, Saint Louis, MO 63110-1081 | 2020-10-16 |
| 1164036851 | Andrea Bumb | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-09-01 |
| 1235741513 | Shannon Ries | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-08-19 |
| 1144832320 | Lacey Bender | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-08-19 |
| 1699386417 | Kristen Bagby | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-08-14 |
| 1720696115 | Abigail Patricia Klatch | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-07-21 |
| 1518575422 | St Louis Childrens Hospital | Clinical Medical Laboratory | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-07-16 |
| 1730707068 | Alyssa Lavalle | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2020-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 363LP0222X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114574837 | Alexandra N Bickhaus | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2019-08-19 |
| 1285112276 | Nichole Gehl | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2018-08-01 |
| 1518312966 | Rebecca Leah Tomlinson Heaven | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2016-05-03 |
| 1295137271 | Mary Lorraine Aubrey | Nurse Practitioner | 1 Childrens Pl, 4250, Saint Louis, MO 63110-1002 | 2014-09-21 |
| 1043555253 | Gina M Quiles | Nurse Practitioner | 1 Childrens Pl, 4s50, Saint Louis, MO 63110-1002 | 2012-11-29 |
| 1437456431 | Lynn C Suresh | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2011-02-28 |
| 1679898910 | Kelly Kathleen Murawski | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2010-03-30 |
| 1760719249 | Anne Marie Gildehaus | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2009-11-04 |
| 1518107457 | Julie Alysse Hoerr | Nurse Practitioner | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2009-03-05 |
| 1730378555 | Jessica Leet | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-10-17 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
Please comment or provide details below to improve the information on DR. CANDACE-RAE DIANA HAISLIP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.