Healthcare Provider Details

I. General information

NPI: 1356307425
Provider Name (Legal Business Name): CANDACE KUGEL CRNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY HEALTH SERVICES RITENOUR BUILDING
UNIVERSITY PARK PA
16802
US

IV. Provider business mailing address

878 N ALLEN ST
STATE COLLEGE PA
16803-2963
US

V. Phone/Fax

Practice location:
  • Phone: 814-865-2633
  • Fax:
Mailing address:
  • Phone: 814-238-6566
  • Fax: 814-238-6566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP000877B
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW008341L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: