Individual
CANDACE C JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
175 MADISON AVE FL 1, MOUNT HOLLY, NJ 08060-2099
(609) 914-6000
Mailing address
PO BOX 95000-2130, PHILADELPHIA, PA 19195-2130
(201) 804-2800
(201) 804-8883
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR12517400
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00300900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NR12517400
REGISTERED NURSE STATE LICENSE
NJ
Enumeration date
08/03/2009
Last updated
08/28/2024
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