Provider Demographics
NPI:1295382794
Name:CARDEN, DELLA
Entity Type:Individual
Prefix:
First Name:DELLA
Middle Name:
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 1:862 OLD CELINA RD
Mailing Address - Street 2:
Mailing Address - City:ALLONS
Mailing Address - State:TN
Mailing Address - Zip Code:38541-6910
Mailing Address - Country:US
Mailing Address - Phone:931-823-3652
Mailing Address - Fax:
Practice Address - Street 1:862 OLD CELINA RD
Practice Address - Street 2:
Practice Address - City:ALLONS
Practice Address - State:TN
Practice Address - Zip Code:38541-6910
Practice Address - Country:US
Practice Address - Phone:931-823-3652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider