Healthcare Provider Details
I. General information
NPI: 1346169182
Provider Name (Legal Business Name): MRS. CANDACE WEEGAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 AUSTIN GRAYBILL RD
NORTH AUGUSTA SC
29860-9251
US
IV. Provider business mailing address
251 BONHILL ST
NORTH AUGUSTA SC
29860-7478
US
V. Phone/Fax
- Phone: 803-278-4272
- Fax:
- Phone: 803-278-4272
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 261718 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: