Healthcare Provider Details

I. General information

NPI: 1578236113
Provider Name (Legal Business Name): CANDICE FORTE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CANDICE ALLUMS

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 W RACE AVE
SEARCY AR
72143-3442
US

IV. Provider business mailing address

803 W RACE AVE
SEARCY AR
72143-3442
US

V. Phone/Fax

Practice location:
  • Phone: 501-236-4452
  • Fax: 888-766-6452
Mailing address:
  • Phone: 501-236-4452
  • Fax: 888-766-6452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number125422
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: