Individual
CANDACE ISABEL ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 N OAK ST, VALDOSTA, GA 31602-1716
(229) 259-0019
Mailing address
4400 IVYDALE CT, VALDOSTA, GA 31602-7632
(229) 375-6699
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN269971
GU
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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