Provider Demographics
NPI:1669840641
Name:POWELL, CANDICE FELIZ (APRN)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:FELIZ
Last Name:POWELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10770 COLUMBIA PIKE STE 300
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4439
Mailing Address - Country:US
Mailing Address - Phone:202-449-2180
Mailing Address - Fax:850-407-9743
Practice Address - Street 1:4331 SWINDON TER
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-6926
Practice Address - Country:US
Practice Address - Phone:202-449-2180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR176269163W00000X
FL11025478363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse