Individual
CANDACE COLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 W MEMORIAL DR, DALLAS, GA 30132-4117
(470) 644-7000
Mailing address
5665 NEW NORTHSIDE DR, SUITE 320, ATLANTA, GA 30328-5831
(770) 874-6907
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN138876
GA
363L00000X
Nurse Practitioner
Primary
RN138876
GA
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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