Healthcare Provider Details

I. General information

NPI: 1992237648
Provider Name (Legal Business Name): CANDICE ELAINE ADAMS DNP, APRN, AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S RACKHAM WAY
MERIDIAN ID
83642-1092
US

IV. Provider business mailing address

5108 N MAIDSTONE WAY
BOISE ID
83713-1367
US

V. Phone/Fax

Practice location:
  • Phone: 208-577-8672
  • Fax: 208-209-6058
Mailing address:
  • Phone: 208-577-8672
  • Fax: 208-939-6106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number55016
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: