Provider Demographics
NPI:1992293120
Name:OSBORNE, CANDACE YONTS (MS, RD)
Entity type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:YONTS
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:NICOLE
Other - Last Name:YONTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:402 BLUFF CITY HWY APT 147
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-4687
Mailing Address - Country:US
Mailing Address - Phone:276-525-0769
Mailing Address - Fax:
Practice Address - Street 1:402 BLUFF CITY HWY APT 147
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-4687
Practice Address - Country:US
Practice Address - Phone:276-525-0769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered