Provider Demographics
NPI:1932392305
Name:URIBARRI, CANDICE K (APRN, CPNP)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:K
Last Name:URIBARRI
Suffix:
Gender:F
Credentials:APRN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10820 WITTMUS DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3886
Mailing Address - Country:US
Mailing Address - Phone:402-514-3600
Mailing Address - Fax:
Practice Address - Street 1:10820 WITTMUS DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3886
Practice Address - Country:US
Practice Address - Phone:402-514-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110882363LP0200X
TX688581163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE110882OtherNE APRN LICENSE
TX688581OtherTX RN LICENSE
TX688581OtherTX RN LICENSE