Provider Demographics
NPI:1831920339
Name:DEAN, CANDACE (LPN)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6133 PEBBLE LN
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33876-6319
Mailing Address - Country:US
Mailing Address - Phone:863-214-4665
Mailing Address - Fax:
Practice Address - Street 1:8200 SPARTA RD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33875-6970
Practice Address - Country:US
Practice Address - Phone:863-471-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5241501164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse