Individual
CANDICE DIANE BOURGEOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
44150 W MARICOPA CASA GRANDE HWY, MARICOPA, AZ 85138-5900
(520) 568-5100
Mailing address
42596 W LUCERA CT, MARICOPA, AZ 85138-4436
(520) 568-5728
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN163005
AZ
Other
Enumeration date
08/20/2010
Last updated
08/20/2010
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