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NPI Code Detail

MEDICARE: MRS. CANDACE PHILLIPS LARAMORE FNP-C

MEDICARE: MRS. CANDACE PHILLIPS LARAMORE FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner69441NM

General Provider Information

NPI Number : 1396463089
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CANDACE PHILLIPS LARAMORE FNP-C
Provider Business Mailing Address
First Line : 1618 E PINE ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-7155
Country : US
Telephone Number : 575-388-1561
Fax Number :
Provider Business Practice Location Address
First Line : 2600 N SILVER ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-7201
Country : US
Telephone Number : 575-388-1889
Fax Number : 575-388-9952
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2022
Last Update Date : 01/29/2025

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Directions to “ MRS. CANDACE PHILLIPS LARAMORE FNP-C” Practice Location

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