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General NPI Number Information
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NPI Number | 1528628542
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Entity Type | Individual
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Provider Name | CANDICE STARR RYAN NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 1614 NC HIGHWAY 56
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City | CREEDMOOR
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State | NC
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Zip | 27522-8297
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Country | US
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Telephone | 919-575-6103
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Fax | 919-575-6817
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Provider Business Mailing Address
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Address Line | PO BOX 986
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City | OXFORD
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State | NC
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Zip | 27565-0986
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Country | US
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Telephone | 919-575-6103
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Fax | 919-575-6817
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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 | 5011915
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License Number State | NC
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