Provider Demographics
NPI:1861619876
Name:FLOOD, CANDICE ANNE (RN NP)
Entity type:Individual
Prefix:MS
First Name:CANDICE
Middle Name:ANNE
Last Name:FLOOD
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 XIMENO AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-2953
Mailing Address - Country:US
Mailing Address - Phone:562-833-2483
Mailing Address - Fax:
Practice Address - Street 1:1066 ATLANTIC AVE STE D
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3400
Practice Address - Country:US
Practice Address - Phone:562-590-2241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247796363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health