Provider Demographics
NPI:1538435482
Name:GILES, CANDACE PATRICE (DO)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:PATRICE
Last Name:GILES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:PATRICE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6829 N 72ND ST STE 4500
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-1724
Practice Address - Country:US
Practice Address - Phone:402-572-3790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDDO06129207VX0000X
NE1087207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics