Provider Demographics
NPI:1841060951
Name:CANDON, CHRISTINE (RN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CANDON
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 1:5518 CHARLOTTE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-2608
Mailing Address - Country:US
Mailing Address - Phone:802-342-0994
Mailing Address - Fax:
Practice Address - Street 1:5518 CHARLOTTE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-2608
Practice Address - Country:US
Practice Address - Phone:802-342-0994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA222254163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice