Provider Demographics
NPI:1679918627
Name:LOBENSTEIN, CANDI R (NP)
Entity type:Individual
Prefix:
First Name:CANDI
Middle Name:R
Last Name:LOBENSTEIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W MAIN ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:CEDAREDGE
Mailing Address - State:CO
Mailing Address - Zip Code:81413-3357
Mailing Address - Country:US
Mailing Address - Phone:970-300-0814
Mailing Address - Fax:970-444-7035
Practice Address - Street 1:120 W MAIN ST UNIT A
Practice Address - Street 2:
Practice Address - City:CEDAREDGE
Practice Address - State:CO
Practice Address - Zip Code:81413-3357
Practice Address - Country:US
Practice Address - Phone:970-300-0814
Practice Address - Fax:970-444-7035
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0990688363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner