Individual ProviderCandace J JohnsonLicensed Vocational NurseNursing Service ProvidersPractice Address755 S Beckham Ave, Tyler, TX 75701-1903(903) 534-4684PECOS EnrollmentBased on the most recent information from CMS, provider Candace J Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:46 AM.Profile DetailsProvider ID1275166837Provider TypeIndividualFull NameJohnson, Candace JGenderFemaleSole ProprietorNoEnumeration Date2/21/2020Last Updated2/21/2020Contact InformationPractice LocationPractice Address755 S Beckham Ave, Tyler, TX 75701-1903Phone(903) 534-4684FaxUnlisted FaxMailing LocationMailing Address755 S Beckham Ave, Tyler, TX 75701-1903Phone(903) 534-4684FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164X00000XPrimaryDescriptionLicensed Vocational NurseNursing Service ProvidersLicense314255TexasProvider IdentifiersIDDescriptionIssuerID341255DescriptionOtherIssuerLVNTexas