Provider Demographics
NPI:1306216825
Name:BARKER, CANDACE LEANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:LEANN
Last Name:BARKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:BARKLEY
Other - Last Name:PEAVY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1400 AFFLINK PL STE 101
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2289
Mailing Address - Country:US
Mailing Address - Phone:205-366-9740
Mailing Address - Fax:205-344-9992
Practice Address - Street 1:171 TOWN CENTER DR
Practice Address - Street 2:SUITE 6
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36205-4102
Practice Address - Country:US
Practice Address - Phone:256-847-3369
Practice Address - Fax:256-847-3469
Is Sole Proprietor?:No
Enumeration Date:2015-09-26
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-116236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily