Provider Demographics
NPI:1679066898
Name:AMOS, CANDACE T (FNP)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:T
Last Name:AMOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:406 TAYLOR ST STE B
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2406
Mailing Address - Country:US
Mailing Address - Phone:256-574-6100
Mailing Address - Fax:256-574-3004
Practice Address - Street 1:406 TAYLOR ST STE B
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768
Practice Address - Country:US
Practice Address - Phone:256-574-6100
Practice Address - Fax:256-574-3004
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-132975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine