Provider Demographics
NPI:1437534195
Name:RYDER, CANDICE (RN)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:RYDER
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 1:17432 SLIPPER SHELL WAY
Mailing Address - Street 2:APT 18
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-6320
Mailing Address - Country:US
Mailing Address - Phone:954-296-5709
Mailing Address - Fax:
Practice Address - Street 1:17432 SLIPPER SHELL WAY
Practice Address - Street 2:APT 18
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-6320
Practice Address - Country:US
Practice Address - Phone:954-296-5709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0047096163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse