Doctor Name: | CANDACE MICHELE CRAVEN |
NPI Number: | 1114258746 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 14178 |
Business Practice Address: | 9408 Apison Pike Ste 174 Ooltewah, TN - 373635977 |
Business Phone Number: | 4233969894 |
Business Fax Number: | 4233969508 |
Mailing Address: | 3852 Candies Creek Lane Nw, CLEVELAND |
State: | TN |
Postal Code: | 373121863 |
Phone Number: | 4233396735 |
Fax Number: | |
NPI Enumeration Date: | 01/21/2010 |
NPI Last Update Date: | 07/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 14178 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |