Provider Demographics
NPI:1457027930
Name:DAUGHTRIDGE, CANDACE (PA-C)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:DAUGHTRIDGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 COMPTONFIELD DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7796
Mailing Address - Country:US
Mailing Address - Phone:252-469-3812
Mailing Address - Fax:
Practice Address - Street 1:2401 ERWIN ROAD SUITE 2600
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-681-0196
Practice Address - Fax:919-681-8521
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program