Provider Demographics
NPI:1861152290
Name:HOLLIS, CANDACE PAIGE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:PAIGE
Last Name:HOLLIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 S JACKSON HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-5773
Mailing Address - Country:US
Mailing Address - Phone:256-383-4447
Mailing Address - Fax:256-381-7999
Practice Address - Street 1:1120 S JACKSON HWY STE 300
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5773
Practice Address - Country:US
Practice Address - Phone:256-383-4447
Practice Address - Fax:256-381-7999
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNF12210636363LF0000X
TN31027363LF0000X
AL3-001324363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF12210636OtherAANP