MEDICARE: CANDI ANTOINETTE WILSON

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
1	363LW0102X	Women's Health Nurse Practitioner	APRN-NP290678	GA

General Provider Information

NPI Number	:	1972466688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDI ANTOINETTE WILSON

Provider Business Mailing Address
First Line	:	300 ARGENTO DR APT 7102
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-5232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 ARGENTO DR APT 7102
Second Line	:	APT 7102
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-5232
Country	:	US
Telephone Number	:	337-459-6142
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

Similar Medicare Providers

1891659231 — HEALTH HAVEN CARE LLC
Practice Location Address:

3208 BAYLOR CIR
MCDONOUGH, GA
30253-6164

Practice Phone: 404-421-2100
Practice Fax:

1699639096 — SHEMMEAH MIRANDA SHANNON
Practice Location Address:

777 GALVESTON WAY
MCDONOUGH, GA
30253-3042

Practice Phone: 706-332-9650
Practice Fax: 706-332-9650

1265396584 — DIVINE HARVEST HOME CARE SERVICES, LLC
Practice Location Address:

2605 CORNWALL DR
MCDONOUGH, GA
30253-6875

Practice Phone: 678-544-9234
Practice Fax: 678-759-1775

1336925080 — KULANI SPA & WELLNESS, LLC
Practice Location Address:

300 ARGENTO DR APT 2101
MCDONOUGH, GA
30253-5237

Practice Phone: 678-884-6555
Practice Fax: 678-826-0772

1538102470 — AMARISH R KAPASI M.D.
Practice Location Address:

2200 PATRICK HENRY PKWY
MCDONOUGH, GA
30253-4207

Practice Phone: 470-713-2000
Practice Fax:

1447325600 — HENRY COUNTY BOARD OF HEALTH
Practice Location Address:

135 HENRY PKWY
MCDONOUGH, GA
30253-6636

Practice Phone: 470-661-0005
Practice Fax: 770-954-2269

Directions to “ CANDI ANTOINETTE WILSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.