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General NPI Number Information
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NPI Number | 1831632348
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Entity Type | Individual
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Provider Name | CANDACE ANN JAMES PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/01/2016
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 1638 N 200 E
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City | LOGAN
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State | UT
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Zip | 84341
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Country | US
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Telephone | 435-754-7120
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Fax |
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Provider Business Mailing Address
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Address Line | 98 EAST 500 SOUTH
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City | PROVIDENCE
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State | UT
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Zip | 84332
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Country | US
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Telephone | 435-553-5915
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 7983862-8900
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 7983862-3102
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License Number State | UT
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