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
Fax: (262) 243-5026
Website:

Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285962605 NPPES
Wisconsin MEDICAID 1285962605

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