Provider Demographics
NPI:1255512000
Name:VAKNIN, CANDICE MARIA (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:MARIA
Last Name:VAKNIN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 CHENEY HWY
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-6356
Mailing Address - Country:US
Mailing Address - Phone:321-385-7210
Mailing Address - Fax:321-425-8536
Practice Address - Street 1:1057 CHENEY HWY UNIT 4
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-6356
Practice Address - Country:US
Practice Address - Phone:321-385-7210
Practice Address - Fax:321-425-8536
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9329589163W00000X
FLPN5164388164W00000X
FLARNP9329589363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse