Provider Demographics
NPI:1205503224
Name:KEYSER, CANDACE HINES (NP)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:HINES
Last Name:KEYSER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5659 PARKWAY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-3792
Mailing Address - Country:US
Mailing Address - Phone:804-381-4361
Mailing Address - Fax:
Practice Address - Street 1:8152 NORTHUMBERLAND HWY
Practice Address - Street 2:
Practice Address - City:HEATHSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22473-3309
Practice Address - Country:US
Practice Address - Phone:804-580-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily