Provider Demographics
NPI:1952568081
Name:SMITH, CANDACE OSBORN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:OSBORN
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:CANDACE
Other - Middle Name:OSBORN
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:50 MEDICAL PARK E DRIVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235
Mailing Address - Country:US
Mailing Address - Phone:205-838-3970
Mailing Address - Fax:205-838-3206
Practice Address - Street 1:50 MEDICAL PARK E DRIVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235
Practice Address - Country:US
Practice Address - Phone:205-838-3970
Practice Address - Fax:205-838-3206
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily