Provider Demographics
NPI:1467210617
Name:LEE, CANDACE ANN
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:ANN
Last Name:LEE
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 1:2000 US HIGHWAY 23 N LOT 67
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-8646
Mailing Address - Country:US
Mailing Address - Phone:330-697-0923
Mailing Address - Fax:
Practice Address - Street 1:2000 US HIGHWAY 23 N LOT 67
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-8646
Practice Address - Country:US
Practice Address - Phone:330-697-0923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker