Individual
CANDACE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
1751 CALLE MEDICO STE O, SANTA FE, NM 87505-4706
(505) 391-4242
(505) 439-7052
Mailing address
7 AVENIDA VISTA GRANDE # B7-302, SANTA FE, NM 87508-9198
(505) 391-4242
(505) 439-7052
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
PA-2015-0062
NM
363A00000X
Physician Assistant
Primary
PA2015-0062
NM
363AM0700X
Medical Physician Assistant
PA2015-0062
NM
Other
Enumeration date
09/02/2015
Last updated
10/01/2024
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