Provider Demographics
NPI:1528359825
Name:MORELAND, CANDICE MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:MARIE
Last Name:MORELAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CANDICE
Other - Middle Name:MARIE
Other - Last Name:PFIESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 MARCLEY DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-2977
Mailing Address - Country:US
Mailing Address - Phone:304-263-8911
Mailing Address - Fax:
Practice Address - Street 1:101 MARCLEY DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-2977
Practice Address - Country:US
Practice Address - Phone:304-263-8911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004431363AM0700X
WV01630363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical