Individual provider · NPI-1

Candice Sheantae Boone, LPN

Licensed Practical Nurse · Newport News, VA

NPI number1700482189
StatusActive
Last updated in NPPESDec 10, 2020

Details

NPI
1700482189
Entity type
Individual (NPI-1)
Name
Candice Sheantae Boone
Credential
LPN
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 10, 2020
Certification date
Dec 10, 2020
Last updated
Dec 10, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
164W00000X Licensed Practical Nurse0002086303VAYes

Practice location

4508 Baughman Ct
Newport News, VA 23607-2214

Phone 757-355-4791

Mailing address

4508 Baughman Ct
Newport News, VA 23607-2214

Phone 757-355-4791

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