Individual
CANDACE S WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5001 E MAIN ST, ERIN, TN 37061-4115
(931) 289-4211
(731) 249-9003
Mailing address
5001 E MAIN ST, ERIN, TN 37061-4115
(931) 289-4211
(731) 249-9003
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
APN16883
TN
207Q00000X
Family Medicine Physician
APN16883
TN
207R00000X
Internal Medicine Physician
APN16883
TN
208000000X
Pediatrics Physician
APN16883
TN
2085R0202X
Diagnostic Radiology Physician
APN16883
TN
208600000X
Surgery Physician
APN16883
TN
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
363LF0000X
Family Nurse Practitioner
Primary
APN16883
TN
Other
Enumeration date
07/31/2012
Last updated
07/24/2024
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