Provider Demographics
NPI:1194090787
Name:CHAUNCY, CANDACE ANN (APN)
Entity type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:ANN
Last Name:CHAUNCY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WOODMONT CROSSING ST
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2100
Mailing Address - Country:US
Mailing Address - Phone:903-826-4404
Mailing Address - Fax:
Practice Address - Street 1:6 WOODMONT CROSSING ST
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2100
Practice Address - Country:US
Practice Address - Phone:903-826-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03664363LA2100X
TX707321363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care