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General NPI Number Information
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NPI Number | 1235502246
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Entity Type | Individual
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Provider Name | CANDACE S BLACK MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 2738 N DECATUR RD
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City | DECATUR
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State | GA
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Zip | 30033-5910
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Country | US
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Telephone | 404-508-8058
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Fax |
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Provider Business Mailing Address
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Address Line | 2738 N DECATUR RD
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City | DECATUR
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State | GA
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Zip | 30033-5910
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Country | US
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Telephone | 866-389-2727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 80843
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CP003390
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License Number State | SD
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200657
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License Number State | ND
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10032702
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP030933
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 29273A
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License Number State | SC
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 13315
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License Number State | CT
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-243461
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License Number State | MT
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Taxonomy #9
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ15119200
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License Number State | NJ
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Taxonomy #10
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209013253
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License Number State | IL
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024190378
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License Number State | VA
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Taxonomy #12
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5020039
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License Number State | NC
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Taxonomy #13
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 119837
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License Number State | WV
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Taxonomy #14
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN280993
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License Number State | GA
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Taxonomy #15
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 314859
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License Number State | AZ
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