Individual
CANDICE D WHITELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4940 VAN NUYS BLVD STE 200, SHERMAN OAKS, CA 91403
(818) 380-2626
(818) 380-2620
Mailing address
8390 CHAMPIONS GATE BLVD, SUITE 215, CHAMPIONS GATE, FL 33896-8310
(407) 390-1677
(407) 390-1765
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
335778
NY
363LF0000X
Family Nurse Practitioner
9295215
FL
363LF0000X
Family Nurse Practitioner
Primary
95004880
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00756650
RAILROAD MEDICARE
FL
Enumeration date
02/03/2009
Last updated
07/13/2018
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