Healthcare Provider Details

I. General information

NPI: 1942940481
Provider Name (Legal Business Name): CANDACE LYNE FILIPPELLI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOINT BASE ELMENDORF-RICHARDSON 5955 ZEAMER AVENUE
ANCHORAGE AK
99506
US

IV. Provider business mailing address

JOINT BASE ELMENDORF-RICHARDSON 5955 ZEAMER AVENUE
ANCHORAGE AK
99506
US

V. Phone/Fax

Practice location:
  • Phone: 907-580-2778
  • Fax:
Mailing address:
  • Phone: 907-580-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number010865
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: