Moore, Candace
Moore, Candace is an individual health care provider with primary practice located at 13133 N Port Washington Rd Suite G-18, Mequon WI 53097-2419. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Moore, Candace can be contacted via phone (262) 243-5000.Contact Information
Primary practice address
13133 N Port Washington Rd Suite G-18
Mequon WI 53097-2419
Phone: (262) 243-5000
Fax: (262) 243-5026
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 3905 | Wisconsin |
Profile Details
| NPI number | 1285962605 |
|---|---|
| LBN Legal business name | Moore, Candace |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 23rd, 2009 |
| Last updated | Feb 25th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285962605 | NPPES |
| Wisconsin | MEDICAID | 1285962605 |
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