Provider Demographics
NPI:1982761078
Name:CANE, CANDACE S (CRNP)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:S
Last Name:CANE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:S
Other - Last Name:PATTISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13880 BRADDOCK RD STE 209
Mailing Address - Street 2:LAVONNA SHADE, OFFICE MANAGER
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2463
Mailing Address - Country:US
Mailing Address - Phone:703-818-2772
Mailing Address - Fax:703-818-2773
Practice Address - Street 1:13880 BRADDOCK RD STE 209
Practice Address - Street 2:LAVONNA SHADE, OFFICE MANAGER
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2463
Practice Address - Country:US
Practice Address - Phone:703-818-2772
Practice Address - Fax:703-818-2773
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017001397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily