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General NPI Number Information
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NPI Number | 1326538257
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Entity Type | Individual
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Provider Name | CANDICE ELAINE COLWELL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 373 S ILLINOIS AVE
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City | OAK RIDGE
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State | TN
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Zip | 37830-6741
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Country | US
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Telephone | 865-483-9825
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Fax |
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Provider Business Mailing Address
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Address Line | 123 PATT LN
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City | POWELL
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State | TN
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Zip | 37849-7502
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Country | US
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Telephone | 865-621-7451
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 41616
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License Number State | TN
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