Provider Demographics
NPI:1316712953
Name:NORSESIAN, CANDICE NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:NICOLE
Last Name:NORSESIAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 AEROSPACE BLVD # 500
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-3910
Mailing Address - Country:US
Mailing Address - Phone:386-226-7917
Mailing Address - Fax:386-226-6082
Practice Address - Street 1:1 AEROSPACE BLVD # 500
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-3910
Practice Address - Country:US
Practice Address - Phone:386-226-7917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029404163WI0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control