Individual
CANDACE LOUISE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25195 SW PARKWAY AVE STE 210, WILSONVILLE, OR 97070-9689
(800) 640-3451
Mailing address
PO BOX 1200, PLEASANT GROVE, UT 84062-1200
(800) 640-3451
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
202010404NPPP
OR
363LA2100X
Acute Care Nurse Practitioner
AP143914
TX
363LF0000X
Family Nurse Practitioner
202010404NPPP
OR
363LF0000X
Family Nurse Practitioner
AP143914
TX
Other
Enumeration date
06/08/2020
Last updated
04/01/2025
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