Individual
RAYMOND CANDELARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3611 S REED RD STE 214, KOKOMO, IN 46902-3828
(765) 776-8700
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7584
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28222844A
IN
363LF0000X
Family Nurse Practitioner
Primary
71012069A
IN
Other
Enumeration date
11/29/2021
Last updated
03/29/2022
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