Provider Demographics
NPI:1356165401
Name:DAY, CANDACE R
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:R
Last Name:DAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 NOBSCOT DR # 1B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-1791
Mailing Address - Country:US
Mailing Address - Phone:317-626-9815
Mailing Address - Fax:
Practice Address - Street 1:3117 NOBSCOT DR # 1B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-1791
Practice Address - Country:US
Practice Address - Phone:317-626-9815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health