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General NPI Number Information
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NPI Number | 1134889272
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Entity Type | Individual
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Provider Name | CANDICE N BROWN FNP
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Gender | Female
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 115 KILDAIRE PARK DR STE 309
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City | CARY
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State | NC
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Zip | 27518-8144
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Country | US
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Telephone | 919-977-3231
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Fax |
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Provider Business Mailing Address
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Address Line | 415 N PINE ST
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City | WENDELL
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State | NC
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Zip | 27591-8910
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Country | US
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Telephone | 919-219-6299
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5015552
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License Number State | NC
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