Provider Demographics
NPI:1790465581
Name:DINGMAN, CANDICE EMMA (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:EMMA
Last Name:DINGMAN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:EMMA
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5167 N STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-9277
Mailing Address - Country:US
Mailing Address - Phone:435-406-1000
Mailing Address - Fax:
Practice Address - Street 1:434 W ASCENSION WAY STE 225
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-2985
Practice Address - Country:US
Practice Address - Phone:801-716-7008
Practice Address - Fax:888-990-1557
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10378822-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner