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General NPI Number Information
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NPI Number | 1457664104
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Entity Type | Individual
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Provider Name | CANDICE LATRICE REYNOLDS PMHNP-BC, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 1418 S STATE ST
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City | DOVER
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State | DE
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Zip | 19901-4948
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Country | US
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Telephone | 302-257-3135
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Fax | 302-526-2410
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Provider Business Mailing Address
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Address Line | 2139 N UNIVERSITY DR PMB 3000
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6134
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Country | US
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Telephone | 302-399-3019
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC005517
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9486111
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN9486111
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AC005680
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | L8-0010481
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License Number State | DE
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0000531
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License Number State | DE
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