Provider Demographics
NPI:1073983870
Name:CARDEN, BLAKE JOHN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:BLAKE
Middle Name:JOHN
Last Name:CARDEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N
Mailing Address - Street 2:STE 403
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:502-758-4840
Mailing Address - Fax:
Practice Address - Street 1:2004 HAYES ST STE 650
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2656
Practice Address - Country:US
Practice Address - Phone:615-321-0200
Practice Address - Fax:615-620-3266
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
TN2878363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical