Healthcare Provider Details

I. General information

NPI: 1336274588
Provider Name (Legal Business Name): CANDYCE PATRICIA VOGEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W SPEEDWAY BLVD
TUCSON AZ
85745-2326
US

IV. Provider business mailing address

1335 N DUSTY HOLLOW CT
TUCSON AZ
85745-8738
US

V. Phone/Fax

Practice location:
  • Phone: 520-770-3435
  • Fax: 520-770-3787
Mailing address:
  • Phone: 520-206-0644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN028267
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: