Provider Demographics
NPI:1275951204
Name:MADDEN, CAROLINE E (PA-C)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:E
Last Name:MADDEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:E
Other - Last Name:ELDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 440194
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0194
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6198
Practice Address - Street 1:1924 ALCOA HWY
Practice Address - Street 2:1924 ALCOA HWY
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-305-9206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2485363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant