Provider Demographics
NPI:1669123402
Name:HURLEY, CANDIDA (MS)
Entity type:Individual
Prefix:
First Name:CANDIDA
Middle Name:
Last Name:HURLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CANDI
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RODRIGUEZ
Mailing Address - Street 1:105365 S HIGHWAY 102
Mailing Address - Street 2:
Mailing Address - City:MCLOUD
Mailing Address - State:OK
Mailing Address - Zip Code:74851-3051
Mailing Address - Country:US
Mailing Address - Phone:405-988-2060
Mailing Address - Fax:
Practice Address - Street 1:105365 S HIGHWAY 102
Practice Address - Street 2:
Practice Address - City:MCLOUD
Practice Address - State:OK
Practice Address - Zip Code:74851-3051
Practice Address - Country:US
Practice Address - Phone:405-988-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator