Provider Demographics
NPI:1265293310
Name:IRELAND, CANDACE (FNP-BC)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:IRELAND
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:
Other - Last Name:KODRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1043 OAKLAWN DR STE A
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3339
Mailing Address - Country:US
Mailing Address - Phone:540-613-1825
Mailing Address - Fax:
Practice Address - Street 1:1043 OAKLAWN DR STE A
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3339
Practice Address - Country:US
Practice Address - Phone:540-613-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189233363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily