Provider Demographics
NPI:1093430761
Name:MOORE, CANDACE CHRISTIAN
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:CHRISTIAN
Last Name:MOORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7340 EDEN BROOK DR APT 922
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1174
Mailing Address - Country:US
Mailing Address - Phone:443-882-7521
Mailing Address - Fax:
Practice Address - Street 1:7340 EDEN BROOK DR APT 922
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1174
Practice Address - Country:US
Practice Address - Phone:443-882-7521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula