Provider Demographics
NPI:1548659238
Name:FREEMAN, CANDICE G (CRNA)
Entity type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:G
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N CEDAR BLUFF RD STE 300
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-3632
Mailing Address - Country:US
Mailing Address - Phone:865-342-9014
Mailing Address - Fax:865-691-0843
Practice Address - Street 1:1900 EXETER RD
Practice Address - Street 2:# 201
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2954
Practice Address - Country:US
Practice Address - Phone:731-343-0402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-18
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN161334163W00000X
TN20181367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse