Candace M Madick FNP

NPI 1558651117 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1558651117
Gender Female
Enumeration Date 04/15/2011
Last Updated 03/19/2012
Entity Type Individual
Active Over 5 years ago
Practice Location
2703 N PONCE DE LEON BLVD
ST AUGUSTINE FL, 32084-2603, US
Phone (904) 824-2838
Fax
Business Location
145 ISLAND COTTAGE WAY
ST AUGUSTINE FL, 32080-4404, US
Phone (904) 471-6629
Fax
Toxanomy
Taxonomy Code 363LF0000X
License State Ohio
License Number COA12301-NP
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According to our database, Candace M Madick FNP NPI is 1558651117, taxonomy code is 363LF0000X and license number is COA12301-NP, license state is located at Ohio. Candace M Madick FNP physically located at 2703 N Ponce De Leon Blvd, St Augustine FL, 32084-2603. NPI Number Candace M Madick FNP has the Individual type.

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1558651117 NPI number is provided on an as is basis without warranty of any kind. 1558651117 is maintained by the National Plan & Provider Enumeration System. The contents of Candace M Madick FNP are for informational purposes only.