Individual
CANDICE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5048 PARRISH ST, PHILADELPHIA, PA 19139-1644
(215) 758-5460
Mailing address
5048 PARRISH ST, PHILADELPHIA, PA 19139-1644
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN293882
PA
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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