Individual
CANDACE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1960 N DATE ST, T OR C, NM 87901-3701
(575) 894-7662
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
62680
NM
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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