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Individual

MRS. CANDACE W CASSADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
104 MEDICAL PARK DR., ANDALUSIA, AL 36420-5357
(334) 222-2562
(334) 222-2725
Mailing address
PO BOX 2699, PENSACOLA, FL 32513-2699

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1082721
AL
363L00000X
Nurse Practitioner
ARNP9327320
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102I504860
MEDICARE PTAN
AL
Enumeration date
05/16/2007
Last updated
02/21/2014
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