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General NPI Number Information
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NPI Number | 1891233714
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Entity Type | Individual
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Provider Name | CANDEE J. EISENHART NP
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Gender | Female
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Dates
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Enumeration Date | 02/11/2017
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Last Update Date | 06/03/2020
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Provider Practice Location Address
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Address Line | 21321 E OCOTILLO RD STE 102
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City | QUEEN CREEK
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State | AZ
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Zip | 85142
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Country | US
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Telephone | 480-815-7074
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Fax | 949-404-6076
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Provider Business Mailing Address
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Address Line | PO BOX 1009
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-1821
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Country | US
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Telephone | 480-815-7074
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Fax | 949-404-6076
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 131305
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License Number State | AZ
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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 | 131305
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License Number State | AZ
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