Provider Demographics
NPI:1114477437
Name:JANDES, CANDICE (FNP)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:JANDES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 COPPERGLOW CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-3649
Mailing Address - Country:US
Mailing Address - Phone:513-502-6604
Mailing Address - Fax:
Practice Address - Street 1:7020 COPPERGLOW CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-3649
Practice Address - Country:US
Practice Address - Phone:513-502-6604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH289460163W00000X
OHF1016331363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse