Riley, Candice L

Riley, Candice L is an individual health care provider with primary practice located at 4048 Evans Ave Suite 303, Fort Myers FL 33901-9322. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Riley, Candice L can be contacted via phone (239) 332-5344.

Contact Information

Primary practice address
4048 Evans Ave Suite 303 Fort Myers FL 33901-9322
Phone: (239) 332-5344
Fax: (239) 332-7246
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APRN2023182 Florida

Profile Details

NPI number 1427048974
LBN Legal business name Riley, Candice L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Jun 10th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427048974 NPPES
Florida Other 000000000 CHAMPUS
Florida Other 430004785 CHAMPUS
Florida Other G1071 CHAMPUS
Florida MEDICAID 033867200 CHAMPUS

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