Provider Demographics
NPI:1326538257
Name:COLWELL, CANDICE ELAINE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:CANDICE
Middle Name:ELAINE
Last Name:COLWELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 PATT LN
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-7502
Mailing Address - Country:US
Mailing Address - Phone:865-621-7451
Mailing Address - Fax:
Practice Address - Street 1:373 S ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6741
Practice Address - Country:US
Practice Address - Phone:865-483-9825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist