Provider Demographics
NPI:1043698699
Name:TANOUE, CANDACE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:
Last Name:TANOUE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:CANDACE
Other - Middle Name:
Other - Last Name:NAKANISHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4530 KENNY ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220
Mailing Address - Country:US
Mailing Address - Phone:614-326-0689
Mailing Address - Fax:
Practice Address - Street 1:4530 KENNY ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220
Practice Address - Country:US
Practice Address - Phone:614-326-0689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03333975183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist