Individual
MS. CANDACE G MCDOUGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
300 STAFFORD STREET, SUITES 154, 161, SPRINGFIELD, MA 01104-2431
(413) 732-1928
(413) 734-1716
Mailing address
300 STAFFORD STREET, SUITES 154, 161, SPRINGFIELD, MA 01104-2431
(413) 732-1928
(413) 734-1716
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
146608
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0345661
—
MA
05
—
110015447A
—
MA
Enumeration date
12/20/2005
Last updated
05/16/2016
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