Individual
MISS CANDY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4410 6TH AVE SE, APT# 115, LACY, WA 98503
(360) 269-5050
Mailing address
4410 6TH AVE SE, #115, LACEY, WA 98503
(360) 269-5050
(360) 878-9664
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00167657
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
294897
NURSE DELEGATE PROVIDER #
WA
Enumeration date
03/19/2014
Last updated
03/19/2014
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