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NPI Code Detail

MEDICARE: CANDACE TRIPPE PHMNP

MEDICARE: CANDACE TRIPPE PHMNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered NurseRN241096GA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerRN241096GA

General Provider Information

NPI Number : 1295444255
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE TRIPPE PHMNP
Provider Business Mailing Address
First Line : 1325 SATELLITE BLVD NW STE 400
Second Line :
City : SUWANEE
State : GA
Zip : 30024-5299
Country : US
Telephone Number : 256-343-9444
Fax Number :
Provider Business Practice Location Address
First Line : 1325 SATELLITE BLVD NW STE 400
Second Line :
City : SUWANEE
State : GA
Zip : 30024-5299
Country : US
Telephone Number : 256-343-9444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2022
Last Update Date : 06/01/2023

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Directions to “ CANDACE TRIPPE PHMNP” Practice Location

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