Provider Demographics
NPI:1750907275
Name:BAILEY, CANDANCE K (RN)
Entity type:Individual
Prefix:
First Name:CANDANCE
Middle Name:K
Last Name:BAILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4992 VIA VENTURA APT 7
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-8246
Mailing Address - Country:US
Mailing Address - Phone:469-348-3009
Mailing Address - Fax:
Practice Address - Street 1:4992 VIA VENTURA APT 7
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-8246
Practice Address - Country:US
Practice Address - Phone:469-348-3009
Practice Address - Fax:972-203-9807
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX859337163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse