Provider Demographics
NPI:1346564184
Name:O'ROURKE, CANDI DAWN (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:CANDI
Middle Name:DAWN
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 SPOTSYLVANIA PKWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-9433
Mailing Address - Country:US
Mailing Address - Phone:540-710-2324
Mailing Address - Fax:540-710-2381
Practice Address - Street 1:4710 SPOTSYLVANIA PKWY
Practice Address - Street 2:SUITE 205
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-9433
Practice Address - Country:US
Practice Address - Phone:540-710-2324
Practice Address - Fax:540-710-2381
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168724363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health