Healthcare Provider Details

I. General information

NPI: 1659905271
Provider Name (Legal Business Name): CANDICE EDWARDS PARISH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MARSHALL ST STE 104
JACKSON MS
39202-1663
US

IV. Provider business mailing address

350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US

V. Phone/Fax

Practice location:
  • Phone: 601-969-6404
  • Fax: 601-973-4541
Mailing address:
  • Phone: 901-226-4003
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number903724
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: