Provider Demographics
NPI:1295429397
Name:SPACKMAN, CANDICE BRITTANY (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:BRITTANY
Last Name:SPACKMAN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4109 CITY POINT DR STE F
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8339
Mailing Address - Country:US
Mailing Address - Phone:267-663-9070
Mailing Address - Fax:
Practice Address - Street 1:4109 CITY POINT DR STE F
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8339
Practice Address - Country:US
Practice Address - Phone:267-663-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1112862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily