Provider Demographics
NPI:1598565400
Name:JAMES, CANDACE (FNP-BC)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:JAMES
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:
Other - Last Name:PENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7471 NE 160TH AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-4922
Mailing Address - Country:US
Mailing Address - Phone:352-484-3746
Mailing Address - Fax:
Practice Address - Street 1:7471 NE 160TH AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-4922
Practice Address - Country:US
Practice Address - Phone:352-484-3746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038282363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily