Provider Demographics
NPI:1831791425
Name:BRANCH, CANDACE N (FNP-C)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:N
Last Name:BRANCH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2430
Mailing Address - Country:US
Mailing Address - Phone:336-527-7000
Mailing Address - Fax:
Practice Address - Street 1:3369 CLINGMAN RD
Practice Address - Street 2:
Practice Address - City:RONDA
Practice Address - State:NC
Practice Address - Zip Code:28670-8708
Practice Address - Country:US
Practice Address - Phone:336-984-3003
Practice Address - Fax:336-835-6521
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF11200089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily