Provider Demographics
NPI:1588013619
Name:MORALES, CANDACE MARIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:MARIE
Last Name:MORALES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3030 PICACHO STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007
Mailing Address - Country:US
Mailing Address - Phone:575-532-4427
Mailing Address - Fax:575-532-4456
Practice Address - Street 1:3485 NORTHRISE DR STE 1
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-6839
Practice Address - Country:US
Practice Address - Phone:575-382-2161
Practice Address - Fax:575-382-2172
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR52219363LF0000X
NMCNP-02995363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily