Individual
CANDANCE AXEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
970 W KING ST, WEST KING, ST AUGUSTINE, FL 32084-8727
(904) 466-4115
Mailing address
970 W KING ST, WEST KING, ST AUGUSTINE, FL 32084-8727
(904) 466-4115
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
252741
FL
Other
Enumeration date
04/13/2015
Last updated
04/13/2015
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