Provider Demographics
NPI:1033891619
Name:MADDEN, CARLEY ANN (APRN)
Entity Type:Individual
Prefix:
First Name:CARLEY
Middle Name:ANN
Last Name:MADDEN
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 1:806 LAUREL CT
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7124
Mailing Address - Country:US
Mailing Address - Phone:501-593-8011
Mailing Address - Fax:
Practice Address - Street 1:502 RICHIE RD
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3309
Practice Address - Country:US
Practice Address - Phone:501-941-0940
Practice Address - Fax:501-941-1875
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225672363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR932384404OtherDRIVER'S LICENSE