Provider Demographics
NPI:1053643452
Name:CARDEN, NATAUSHA M
Entity Type:Individual
Prefix:
First Name:NATAUSHA
Middle Name:M
Last Name:CARDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27155 FAIRFAX ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5132
Mailing Address - Country:US
Mailing Address - Phone:248-416-8779
Mailing Address - Fax:
Practice Address - Street 1:27155 FAIRFAX ST
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5132
Practice Address - Country:US
Practice Address - Phone:248-416-8779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI631322172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker