Provider Demographics
NPI:1083283071
Name:TURNER, CANDACE LACY (MS, RDN, LD)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:LACY
Last Name:TURNER
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 BELLINGRATH GDNS
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-6488
Mailing Address - Country:US
Mailing Address - Phone:501-499-5760
Mailing Address - Fax:
Practice Address - Street 1:1965 BELLINGRATH GDNS
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-6488
Practice Address - Country:US
Practice Address - Phone:501-499-5760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1552133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered