Healthcare Provider Details

I. General information

NPI: 1922873512
Provider Name (Legal Business Name): CANDICE KAY FELIX NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2023
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6585 N ORACLE RD
TUCSON AZ
85704-5614
US

IV. Provider business mailing address

6585 N ORACLE RD
TUCSON AZ
85704-5614
US

V. Phone/Fax

Practice location:
  • Phone: 520-229-2080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number300560
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: