Provider Demographics
NPI:1710264809
Name:YADEN, CAROL (APRN-C)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:YADEN
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:SUE
Other - Last Name:YADEN-PEAVLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN-C
Mailing Address - Street 1:217 ELM TREE LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40507-2117
Mailing Address - Country:US
Mailing Address - Phone:859-257-8801
Mailing Address - Fax:
Practice Address - Street 1:217 ELM TREE LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-2117
Practice Address - Country:US
Practice Address - Phone:859-257-8801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily