Provider Demographics
NPI:1679901599
Name:HEUSER, CANDICE MICHELLE (MSN, APN, NP-C)
Entity type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:MICHELLE
Last Name:HEUSER
Suffix:
Gender:F
Credentials:MSN, APN, NP-C
Other - Prefix:MS
Other - First Name:CANDICE
Other - Middle Name:MICHELLE
Other - Last Name:SEAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2501 CITICO AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1127
Mailing Address - Country:US
Mailing Address - Phone:423-697-2000
Mailing Address - Fax:423-697-2320
Practice Address - Street 1:2501 CITICO AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404
Practice Address - Country:US
Practice Address - Phone:423-697-2000
Practice Address - Fax:423-697-2320
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000017846363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003146227CMedicaid
TNQ006009Medicaid
TN6006334OtherBCBS
P01276011OtherRR MEDICARE
10350I1466Medicare PIN