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MRS. CANDACE C WATERS MSN, FNP-BC, CDE
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1962496554
Individual Registrant:MRS. CANDACE C WATERS MSN, FNP-BC, CDE
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
124 BETTIS ACADEMY RD GRANITEVILLE, SC 29829-3107 US
Tel: 803-392-3724 Fax: 803-234-5593
Tel: 803-392-3724 Fax: 803-234-5593
Contact information for business:
367 S. GULPH RD ATT: IPM CREDENTIALING KING OF PRUSSIA, PA 19406-3121 US
Tel: 803-392-3724 Fax: --
Tel: 803-392-3724 Fax: --
Registration Information:
NPI: 1962496554
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | SC | 459 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
