Provider Demographics
NPI:1326618802
Name:CARIUS, BRADEN JAMES (PA)
Entity Type:Individual
Prefix:
First Name:BRADEN
Middle Name:JAMES
Last Name:CARIUS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 ISABELLA LN
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-4215
Mailing Address - Country:US
Mailing Address - Phone:615-768-8021
Mailing Address - Fax:615-768-8022
Practice Address - Street 1:890 ISABELLA LN
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4215
Practice Address - Country:US
Practice Address - Phone:615-768-8021
Practice Address - Fax:615-768-8022
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN5186363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program