Tillman, Candace Marvenia

Tillman, Candace Marvenia is an individual health care provider with primary practice located at 477 Windsor St. Sw Ste. 309, Atlanta GA 30312. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as her primary health care specialty. Tillman, Candace Marvenia can be contacted via phone (404) 688-9202.

Contact Information

Primary practice address
477 Windsor St. Sw Ste. 309 Atlanta GA 30312
Fax: (404) 880-9435
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X RN142932 Georgia

Profile Details

NPI number 1871865113
LBN Legal business name Tillman, Candace Marvenia
Credentials RNC, MS, WHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2012
Last updated Feb 2nd, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871865113 NPPES
Georgia Other RN142932 STATE OF GEORGIA

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