| NPI | 1801412242 |
|---|---|
| Former Name | CANDACE KIDWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179004) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024179004) |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2024-01-31 |