Provider Demographics
NPI:1417493198
Name:HOWARD, CANDACE (IBCLC)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:MICHELLE
Other - Last Name:SCARBROUGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IBCLC
Mailing Address - Street 1:1512 COLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2828
Mailing Address - Country:US
Mailing Address - Phone:865-888-4579
Mailing Address - Fax:
Practice Address - Street 1:1512 COLEMAN RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2828
Practice Address - Country:US
Practice Address - Phone:865-888-4579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL-13096174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN