Provider Demographics
NPI:1295218949
Name:MACK, CAROLINE CATON (PA-C)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:CATON
Last Name:MACK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 KENESAW DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-5206
Mailing Address - Country:US
Mailing Address - Phone:615-473-5159
Mailing Address - Fax:
Practice Address - Street 1:1701 KENESAW DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-5206
Practice Address - Country:US
Practice Address - Phone:615-473-5159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant