Individual provider · Type 1 NPI
Candace Marvenia Tillman, RNC, MS, WHNP-BC
Adult Health Nurse Practitioner · Conyers, GA
NPI number
1871865113
Active
Practice location
3230 Old Church Cv NE
Conyers, GA 30012-2647
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | RN142932 (GA) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | RN142932 (GA) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1871865113
Candace Marvenia Tillman, RNC, MS, WHNP-BC's National Provider Identifier is 1871865113, issued on Feb 2, 2012. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Conyers, GA. The record was last updated on Sep 8, 2024.