Healthcare Provider Details

I. General information

NPI: 1336065838
Provider Name (Legal Business Name): CANDACE PRATER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 MONTGOMERY HWY STE 200
VESTAVIA HILLS AL
35216-2830
US

IV. Provider business mailing address

3505 BELLE MEADE LN
MOUNTAIN BRK AL
35223-1503
US

V. Phone/Fax

Practice location:
  • Phone: 205-825-4673
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-069684
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: