Provider Demographics
NPI:1376729335
Name:SANDAL, CANDACE LEA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:LEA
Last Name:SANDAL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 BELLEVUE RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-3431
Mailing Address - Country:US
Mailing Address - Phone:302-366-0500
Mailing Address - Fax:302-451-6737
Practice Address - Street 1:451 BELLEVUE RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3431
Practice Address - Country:US
Practice Address - Phone:302-366-0500
Practice Address - Fax:302-451-6737
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily