Healthcare Provider Details

I. General information

NPI: 1164338596
Provider Name (Legal Business Name): CANDACE FRANKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 MAGUIRE PL
WALDORF MD
20601-5508
US

IV. Provider business mailing address

401 POST OFFICE RD
WALDORF MD
20602-2738
US

V. Phone/Fax

Practice location:
  • Phone: 301-520-1187
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR186278
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: