Provider Demographics
NPI:1568254290
Name:SMITH, CANDRA JORDAN (CLD)
Entity type:Individual
Prefix:MRS
First Name:CANDRA
Middle Name:JORDAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7720 CONIFER DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-4540
Mailing Address - Country:US
Mailing Address - Phone:909-273-8178
Mailing Address - Fax:
Practice Address - Street 1:7720 CONIFER DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4540
Practice Address - Country:US
Practice Address - Phone:909-273-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU1-202513374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula