Individual provider · Type 1 NPI

Candle Johnson, CPNP

Pediatric Nurse Practitioner · Fort Worth, TX

NPI number 1508312067 Active

Practice location

2600 E Berry St
Fort Worth, TX 76105-4750

Fax (817) 347-4639

Mailing address

PO Box 733784
Dallas, TX 75373-3784

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X747188 (TX)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1508312067

Candle Johnson, CPNP's National Provider Identifier is 1508312067, issued on Aug 25, 2016. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Fort Worth, TX. The record was last updated on Apr 29, 2021.