Provider Demographics
NPI:1265201024
Name:CANDARINI, CASIE ANNE (FNP-C, APRN)
Entity type:Individual
Prefix:MRS
First Name:CASIE
Middle Name:ANNE
Last Name:CANDARINI
Suffix:
Gender:F
Credentials:FNP-C, APRN
Other - Prefix:
Other - First Name:CASIE
Other - Middle Name:ANNE
Other - Last Name:WOMBACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8486 MCCULLOUGH CLUB DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-6011
Mailing Address - Country:US
Mailing Address - Phone:732-239-9349
Mailing Address - Fax:
Practice Address - Street 1:2275 INDIA HOOK RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1223
Practice Address - Country:US
Practice Address - Phone:803-329-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily