Individual
CANDACE N BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
(217) 535-3662
Mailing address
1130 S 6TH ST, SPRINGFIELD, IL 62703-2406
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
309001472
IL
363LF0000X
Family Nurse Practitioner
Primary
209003332
IL
Other
Enumeration date
12/06/2006
Last updated
09/14/2020
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