Healthcare Provider Details

I. General information

NPI: 1326378662
Provider Name (Legal Business Name): CANDACE MCWHIRTER DAVIS FNPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CANDACE L MCWHIRTER

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 RED BRIDGE RD
ELLSWORTH ME
04605-3227
US

IV. Provider business mailing address

775 RED BRIDGE RD
ELLSWORTH ME
04605-3227
US

V. Phone/Fax

Practice location:
  • Phone: 207-300-3675
  • Fax: 888-226-6431
Mailing address:
  • Phone: 207-300-3675
  • Fax: 888-226-6431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP201167
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number072896-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: