Healthcare Provider Details

I. General information

NPI: 1952897324
Provider Name (Legal Business Name): CANDACE ARNELL WEST REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6585 FM 1511
CENTERVILLE TX
75833
US

IV. Provider business mailing address

6585 FM 1511
CENTERVILLE TX
75833-2953
US

V. Phone/Fax

Practice location:
  • Phone: 979-571-7759
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number938841
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: