Healthcare Provider Details

I. General information

NPI: 1720916653
Provider Name (Legal Business Name): CANDY IRVING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4181 COULBOURN MILL RD
SALISBURY MD
21804-2722
US

IV. Provider business mailing address

31293 LITTLE CREEK LN
LAUREL DE
19956-3938
US

V. Phone/Fax

Practice location:
  • Phone: 410-330-7771
  • Fax:
Mailing address:
  • Phone: 302-864-4966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number2018102944
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: