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General NPI Number Information
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NPI Number | 1629850987
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Entity Type | Individual
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Provider Name | CANDICE DANBURY FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 1075 HEATHER GREEN DR
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City | COLUMBIA
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State | SC
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Zip | 29229-7831
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Country | US
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Telephone | 803-382-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 S OCEAN DR STE 209
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City | HOLLYWOOD
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State | FL
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Zip | 33019-2915
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Country | US
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Telephone | 800-226-8874
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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 | 28007
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License Number State | SC
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