Provider Demographics
NPI:1851674386
Name:WINN, CANDICE (RPH)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:WINN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-3507
Mailing Address - Country:US
Mailing Address - Phone:317-558-1452
Mailing Address - Fax:317-558-1473
Practice Address - Street 1:6110 E 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-3507
Practice Address - Country:US
Practice Address - Phone:317-558-1452
Practice Address - Fax:317-558-1473
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019044A183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist