Provider Demographics
NPI:1114258746
Name:CRAVEN, CANDACE MICHELE (NP-C)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:MICHELE
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:MICHELE
Other - Last Name:AKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3852 CANDIES CREEK LANE NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-1863
Mailing Address - Country:US
Mailing Address - Phone:423-339-6735
Mailing Address - Fax:
Practice Address - Street 1:9408 APISON PIKE STE 174
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-5977
Practice Address - Country:US
Practice Address - Phone:423-396-9894
Practice Address - Fax:423-396-9508
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily