Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Candace Marvenia Tillman, RNC, MS, WHNP-BC

Individual provider Women's Health Nurse Practitioner · NPI 1871865113

MS. Candace Marvenia Tillman, RNC, MS, WHNP-BC is a Nurse Practitioner in Conyers, Georgia. Qualified in 2005, 21 years ago. Practices with Vitality Ageless Center LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
21
Licensed in
GA
In the registry since
2012
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.

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Practice location Address checks out

3230 Old Church Cv NE
Conyers, GA 30012-2647
Phone: (678) 221-8855
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence RN142932 (GA)
Women's Health Nurse Practitioner Taxonomy 363LW0102X · Licence RN142932 (GA)

Record details

NPI number1871865113
Entity typeIndividual (Type 1)
GenderFemale
Credentials RNC , MS , WHNP-BC
Sole proprietorNo
NPI enumeratedFebruary 2, 2012
Last updated in NPPESSeptember 8, 2024
Certification dateSeptember 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Vitality Ageless Center Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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