CANDLE JOHNSON (NPI# 1508312067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508312067 |
| Entity Type | Individual |
| Full Name | CANDLE JOHNSON |
| Credential | CPNP |
| Practice Address |
2600 E Berry St Fort Worth TX 76105-4750 |
| Mailing Address |
Po Box 99371 Fort Worth TX 76199-0371 |
| Practice Telephone | 8173474600 |
| Practice Fax Number | 8173474639 |
| Mailing Telephone | 6828851855 |
| Mailing Fax Number | 6828857347 |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
747188 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2600 E BERRY ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76105-4750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235243783 | Juan T Cocjin | Pediatrics | 2600 E Berry St, Fort Worth, TX 76105-4750 | 2006-08-19 |
| 1407202435 | Shawne Barron | Dentist | 2600 E Berry St, Fort Worth, TX 76105-4750 | 2016-05-09 |
| 1649591355 | Jonathan Erik Suarez | Speech-Language Pathologist | 2600 E Berry St, Fort Worth, TX 76105-4750 | 2010-06-16 |
| 1306165766 | Monica P Goyal | Pediatrics | 2600 E Berry St, Fort Worth, TX 76105-4750 | 2010-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477030567 | Brandon Ronald Lee | Optometrist | 2644 E Berry St., Fort Worth, TX 76105 | 2018-07-23 |
| 1366935165 | National Vision, Inc. | Technician/Technologist | 2644 East Berry Street, Fort Worth, TX 76105 | 2018-06-07 |
| 1609363100 | Courtney Mae Gramley | Specialist/Technologist | 1201 Wesleyan St., Fort Worth, TX 76105 | 2018-04-19 |
| 1992213078 | Fresenius Medical Care Se Fort Worth, LLC | Clinic/Center | 3708 E Rosedale St, Fort Worth, TX 76105 | 2018-01-11 |
| 1285978692 | Wal-mart Stores Texas LLC | Technician/Technologist | 2900 Renaissance Square, Fort Worth, TX 76105 | 2012-11-26 |
| 1548584998 | Access Dental of Berry, P.a. | Dentist | 4201 E. Berry Street, Suite #15, Fort Worth, TX 76105 | 2010-03-15 |
| 1811211261 | Access Dental of Rosedale P.a. | Dentist | 3620 E. Rosedale Street, Fort Worth, TX 76105 | 2010-03-15 |
| 1396345799 | Danielle Hampton | Pharmacist | Walmart Pharmacy, 2900 Renaissance Square, Fort Worth, TX 76105 | 2020-10-27 |
| 1174041578 | Destonee Wilson | Physician Assistant | 1650 S Beach St, Fort Worth, TX 76105 | 2017-09-06 |
| 1184019929 | Sheelarani Joseph | Nurse Practitioner | 1650 S Beach St, Fort Worth, TX 76105 | 2015-03-30 |
| Find all providers in zip 76105 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770182636 | Jenna Donlon | Nurse Practitioner | 3201 Western Center Blvd Ste 125, Fort Worth, TX 76137-7135 | 2020-10-21 |
| 1023594009 | Erica M Lucas | Nurse Practitioner | 800 8th Ave Ste 200, Fort Worth, TX 76104-2619 | 2018-07-13 |
| 1003280686 | Susan Akberzie | Nurse Practitioner | 3400 Texas Sage Trl Ste 148, Fort Worth, TX 76177 | 2015-11-19 |
| 1427489400 | Brenda Bosch | Nurse Practitioner | 11807 Med Park Dr, Ste 365, Fort Worth, TX 76028-3509 | 2013-12-02 |
| 1447535463 | Anamarina Jarecke | Nurse Practitioner | 5300 Buchanan St, Fort Worth, TX 76114-1304 | 2011-10-21 |
| 1770873077 | Michelle Beatrice Oconnor | Nurse Practitioner | 6239 Granbury Rd, Fort Worth, TX 76133-3401 | 2011-04-08 |
| 1912208687 | Andrea Madeliene Newman | Nurse Practitioner | 901 7th Ave Ste 120, Fort Worth, TX 76104-2724 | 2010-11-10 |
| 1629306709 | Autumn Brianne Morris | Nurse Practitioner | 901 W Rosedale St, Fort Worth, TX 76104-4672 | 2009-11-30 |
| 1235466624 | Courtney Shea Stewart | Nurse Practitioner | 5917 Yosemite Dr, Fort Worth, TX 76112-3938 | 2009-11-06 |
| 1548412018 | Christie Ramirez | Nurse Practitioner | 8376 Mojave Trl, Fort Worth, TX 76116-3638 | 2008-10-16 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76105 |
Please comment or provide details below to improve the information on CANDLE JOHNSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.