Provider Demographics
NPI:1649621228
Name:MACARI, CANDICE ELIZABETH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:ELIZABETH
Last Name:MACARI
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1564 E QUAIL CANYON DR
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-6776
Mailing Address - Country:US
Mailing Address - Phone:925-719-2786
Mailing Address - Fax:
Practice Address - Street 1:169 N GATEWAY DR STE 175
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9825
Practice Address - Country:US
Practice Address - Phone:435-565-6043
Practice Address - Fax:435-220-2030
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2022-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT11170828-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant