Healthcare Provider Details

I. General information

NPI: 1629523949
Provider Name (Legal Business Name): CANDACE PERRY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 DELAWARE AVE
WILMINGTON DE
19806-4704
US

IV. Provider business mailing address

1016 DELAWARE AVE
WILMINGTON DE
19806-4704
US

V. Phone/Fax

Practice location:
  • Phone: 302-468-4530
  • Fax:
Mailing address:
  • Phone: 302-468-4530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP034650
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0072973
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0011045
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: