Provider Demographics
NPI:1356474613
Name:NORRIS, CANDACE
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:NORRIS
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 1:8391 MAJESTIC DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-4704
Mailing Address - Country:US
Mailing Address - Phone:907-563-5282
Mailing Address - Fax:907-563-7419
Practice Address - Street 1:PLANNED PARENTHOOD
Practice Address - Street 2:4001 LAKE OTIS PKWY
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5200
Practice Address - Country:US
Practice Address - Phone:907-770-9711
Practice Address - Fax:907-563-7419
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily