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General NPI Number Information
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NPI Number | 1679824973
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Entity Type | Individual
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Provider Name | CANDANCE EUNGENIA JUDKINS
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Gender | Female
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 801 NORTH ST E
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City | TALLADEGA
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State | AL
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Zip | 35160-2529
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Country | US
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Telephone | 256-362-3005
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Fax | 256-268-5019
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Provider Business Mailing Address
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Address Line | 5579 CHESHIRE COVE PL
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City | MC CALLA
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State | AL
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Zip | 35111-5023
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Country | US
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Telephone | 205-747-7957
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-135397
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 1-135397
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1-135397
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License Number State | AL
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