Healthcare Provider Details

I. General information

NPI: 1982930202
Provider Name (Legal Business Name): CANDACE A BECKER R.N.,CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CANDACE A NAEGELE

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/26/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5224 E I 240 SERVICE RD STE 201
OKLAHOMA CITY OK
73135-2607
US

IV. Provider business mailing address

7800 NW 85TH TER
OKLAHOMA CITY OK
73132-3385
US

V. Phone/Fax

Practice location:
  • Phone: 405-608-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberR0053914
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: