Provider Demographics
NPI:1265239065
Name:MADDEN, CANDACE LEANN (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:LEANN
Last Name:MADDEN
Suffix:
Gender:
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:LEANN
Other - Last Name:FACIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:PO BOX 1522
Mailing Address - Street 2:
Mailing Address - City:LOGANDALE
Mailing Address - State:NV
Mailing Address - Zip Code:89021-1522
Mailing Address - Country:US
Mailing Address - Phone:702-413-2885
Mailing Address - Fax:702-789-5519
Practice Address - Street 1:4730 LEAVITT ST # 1522
Practice Address - Street 2:
Practice Address - City:LOGANDALE
Practice Address - State:NV
Practice Address - Zip Code:89021-9987
Practice Address - Country:US
Practice Address - Phone:702-413-2885
Practice Address - Fax:702-789-5519
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN33486163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse