Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 30081 | AL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 2013-01680 | NC |
NPI | 1396800355 |
---|---|
Provider Name | Candace Yvonne Parker-Autry |
First Address | Winston Salem, NC 27101-3006 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 18/02/2016 |