Individual
CANDACE HAYMORE BURCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
401 TECHNOLOGY LN, SUITE 200, MOUNT AIRY, NC 27030-6692
(336) 789-2922
(336) 789-0856
Mailing address
401 TECHNOLOGY LN, SUITE 200, MOUNT AIRY, NC 27030-6692
(336) 789-2922
(336) 789-0856
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201941
NC
363LF0000X
Family Nurse Practitioner
201941
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7005738
—
NC
Enumeration date
02/26/2007
Last updated
12/12/2017
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