Provider Demographics
NPI:1477120392
Name:AUBRY, CANDICE DEANNA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:DEANNA
Last Name:AUBRY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:690 WEST LINCOLN HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2514
Mailing Address - Country:US
Mailing Address - Phone:610-873-5437
Mailing Address - Fax:484-713-5073
Practice Address - Street 1:690 WEST LINCOLN HIGHWAY
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2514
Practice Address - Country:US
Practice Address - Phone:610-873-5437
Practice Address - Fax:484-713-5073
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023842208000000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No208000000XAllopathic & Osteopathic PhysiciansPediatrics