Healthcare Provider Details

I. General information

NPI: 1184651945
Provider Name (Legal Business Name): CANDACE DENISE FLOYD RN MSN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD
DECATUR GA
30033-4004
US

IV. Provider business mailing address

6030 LAKE OAK LNDG E
CUMMING GA
30040-9514
US

V. Phone/Fax

Practice location:
  • Phone: 404-728-7614
  • Fax:
Mailing address:
  • Phone: 678-513-8335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN128591
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: