Provider Demographics
NPI:1710218748
Name:HUNT, CANDACE CARTER (FNP)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:CARTER
Last Name:HUNT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 BAUM DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7360
Mailing Address - Country:US
Mailing Address - Phone:865-584-5727
Mailing Address - Fax:865-450-9904
Practice Address - Street 1:801 N WEISGARBER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2706
Practice Address - Country:US
Practice Address - Phone:865-584-8588
Practice Address - Fax:865-584-3364
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN14929363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1519577Medicaid
TN103I503968Medicare PIN