Provider Demographics
NPI:1629850987
Name:DANBURY, CANDICE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:DANBURY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:
Other - Last Name:NOVAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3800 S OCEAN DR STE 209
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2915
Mailing Address - Country:US
Mailing Address - Phone:800-226-8874
Mailing Address - Fax:
Practice Address - Street 1:1075 HEATHER GREEN DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7831
Practice Address - Country:US
Practice Address - Phone:803-382-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28007363LF0000X
SCAPN.28007363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily