Healthcare Provider Details

I. General information

NPI: 1679901599
Provider Name (Legal Business Name): CANDICE MICHELLE HEUSER MSN, APN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. CANDICE MICHELLE SEAY

II. Dates (important events)

Enumeration Date: 10/31/2013
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 CITICO AVE
CHATTANOOGA TN
37404
US

IV. Provider business mailing address

2501 CITICO AVE
CHATTANOOGA TN
37404-1127
US

V. Phone/Fax

Practice location:
  • Phone: 423-697-2000
  • Fax: 423-697-2320
Mailing address:
  • Phone: 423-697-2000
  • Fax: 423-697-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000017846
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: