Individual
CANDACE FUNDERBURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
835 OLD YORK RD, JENKINTOWN, PA 19046-1601
(866) 389-2727
Mailing address
835 OLD YORK RD, JENKINTOWN, PA 19046-1601
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP019707
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912285198
—
PA
Enumeration date
01/30/2019
Last updated
04/16/2019
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