Provider Demographics
NPI:1447628011
Name:POLITE, CANDACE NICOLE (NP-C)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:NICOLE
Last Name:POLITE
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5532 BLUE MOON DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-4212
Mailing Address - Country:US
Mailing Address - Phone:310-482-9203
Mailing Address - Fax:
Practice Address - Street 1:3620 AUSTIN BLUFFS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6631
Practice Address - Country:US
Practice Address - Phone:719-325-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-12
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS876850363LF0000X
COAPN.1000664-NP363L00000X
CAF07151394363L00000X
CA716817363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily