Individual
MRS. CANDACE C WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC, CDE
Contact information
Practice address
124 BETTIS ACADEMY RD, GRANITEVILLE, SC 29829-3107
(803) 392-3724
(803) 234-5593
Mailing address
367 S. GULPH RD, ATT: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(803) 392-3724
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
459
SC
Other
Enumeration date
09/09/2005
Last updated
09/23/2020
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