Provider Demographics
NPI:1023534401
Name:THOMAS, CANDACE DANIELLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:DANIELLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CANDACE
Other - Middle Name:DANIELLE
Other - Last Name:MATHERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0360
Mailing Address - Country:US
Mailing Address - Phone:888-339-6065
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:1998 HENDERSONVILLE RD STE 53
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2192
Practice Address - Country:US
Practice Address - Phone:828-585-5489
Practice Address - Fax:855-308-2340
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP02580824OtherRAILROAD MEDICARE
NC1023534401Medicaid
NCNNE256AOtherMEDICARE
NC20D34OtherBCBS NC