Provider Demographics
NPI:1477924207
Name:CANDLE, CIARA NICHOLE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CIARA
Middle Name:NICHOLE
Last Name:CANDLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CIARA
Other - Middle Name:NICHOLE
Other - Last Name:CICCOLELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6300 N WICKHAM RD # 130418
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-2028
Mailing Address - Country:US
Mailing Address - Phone:321-477-0900
Mailing Address - Fax:321-517-0333
Practice Address - Street 1:6300 N WICKHAM RD # 130-418
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2028
Practice Address - Country:US
Practice Address - Phone:321-477-0900
Practice Address - Fax:321-517-0333
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9469800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily