Provider Demographics
NPI:1154719698
Name:MIZE, CANDACE CHERIE (APRN)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:CHERIE
Last Name:MIZE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 DOCTOR CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6502
Mailing Address - Country:US
Mailing Address - Phone:800-491-0909
Mailing Address - Fax:478-987-7747
Practice Address - Street 1:3312 NORTHSIDE DR BLDG D
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2500
Practice Address - Country:US
Practice Address - Phone:800-491-0909
Practice Address - Fax:478-987-7747
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN190811363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily