| Doctor Name: | MS. CANDICE PIKE CLARK |
| NPI Number: | 1063852572 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 5006255 |
| Business Practice Address: | 421 N Holly Ave Ste. C Siler City, NC - 273443076 |
| Business Phone Number: | 9196633360 |
| Business Fax Number: | |
| Mailing Address: | 1600 Perimeter Park Dr, Ste. 225 MORRISVILLE |
| State: | NC |
| Postal Code: | 275608421 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/28/2013 |
| NPI Last Update Date: | 01/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5006255 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |