Provider Demographics
NPI:1215004270
Name:BRADEN, KAREN FAYE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:FAYE
Last Name:BRADEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 RUSH CHAPEL RD NE
Mailing Address - Street 2:
Mailing Address - City:ADAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30103-5025
Mailing Address - Country:US
Mailing Address - Phone:706-291-6170
Mailing Address - Fax:
Practice Address - Street 1:1042 RED BUD RD NE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2081
Practice Address - Country:US
Practice Address - Phone:706-629-9139
Practice Address - Fax:706-629-9080
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist