Individual
MRS. CANDACE HURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
21701 W 11 MILE RD STE 5, SOUTHFIELD, MI 48076-3713
(248) 757-7587
Mailing address
21701 W 11 MILE RD STE 5, SOUTHFIELD, MI 48076-3713
(248) 757-7587
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
814390
NV
363LP2300X
Primary Care Nurse Practitioner
Primary
4704247696
MI
363LP2300X
Primary Care Nurse Practitioner
814390
NV
Other
Enumeration date
09/06/2018
Last updated
12/03/2022
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