Provider Demographics
NPI:1144382045
Name:WATSON, CANDACE GIBBS (RN)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:GIBBS
Last Name:WATSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 RIVERCREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-9001
Mailing Address - Country:US
Mailing Address - Phone:252-902-2327
Mailing Address - Fax:252-413-1446
Practice Address - Street 1:201 GOVERNMENT CIR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-8198
Practice Address - Country:US
Practice Address - Phone:252-902-2327
Practice Address - Fax:252-413-1446
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC087141163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health