Mynatt, Candace L
Mynatt, Candace L is an individual health care provider with primary practice located at 1875 Century Blvd Ne Suite 150, Atlanta GA 30345-3319. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Mynatt, Candace L can be contacted via phone (404) 633-4595.Contact Information
Primary practice address
1875 Century Blvd Ne Suite 150
Atlanta GA 30345-3319
Phone: (404) 633-4595
Fax: (404) 633-6637
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | RN127464 | Georgia |
Profile Details
| NPI number | 1285681213 |
|---|---|
| LBN Legal business name | Mynatt, Candace L |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285681213 | NPPES |
| Georgia | MEDICAID | 00924668 |
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