Provider Demographics
NPI:1376067967
Name:WILLETT, CANDACE MARY (PPCNP-BC)
Entity type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:MARY
Last Name:WILLETT
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Gender:F
Credentials:PPCNP-BC
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Mailing Address - Street 1:11325 SEVEN LOCKS RD STE 290
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3235
Mailing Address - Country:US
Mailing Address - Phone:240-507-5110
Mailing Address - Fax:844-682-8102
Practice Address - Street 1:2440 M ST NW STE 205
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-955-0003
Practice Address - Fax:866-457-0397
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2024-08-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR267122363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics