Individual
KANDISE J VANDYNE PMHNP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1105 MEMORIAL DR, ARTESIA, NM 88210-1189
(575) 746-9848
Mailing address
1105 MEMORIAL DR, ARTESIA, NM 88210-1189
(970) 623-3542
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
77982
NM
Other
Enumeration date
07/30/2024
Last updated
09/09/2024
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