Individual
CANDICE STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1 PIONEER PATH, MAN, WV 25635-1235
(304) 583-7295
(304) 583-7436
Mailing address
1 PIONEER PATH, MAN, WV 25635-1235
(304) 824-5806
(304) 824-5804
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN75610
WV
Other
Enumeration date
09/10/2014
Last updated
02/16/2017
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