Provider Demographics
NPI:1619450095
Name:WRAY, CANDY ELAINE (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CANDY
Middle Name:ELAINE
Last Name:WRAY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:CANDY
Other - Middle Name:ELAINE
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3104 APACHE DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-7405
Mailing Address - Country:US
Mailing Address - Phone:870-932-2499
Mailing Address - Fax:870-932-2401
Practice Address - Street 1:3104 APACHE DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-7405
Practice Address - Country:US
Practice Address - Phone:870-932-2499
Practice Address - Fax:870-932-2401
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005863207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine