Provider Demographics
NPI:1356929624
Name:MORELAND, CAROLINE SABBATINI (PA-C)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:SABBATINI
Last Name:MORELAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:SABBATINI
Other - Last Name:MORELAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:1125 SCHILLING BLVD E # 105TH
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-7078
Mailing Address - Country:US
Mailing Address - Phone:901-624-3333
Mailing Address - Fax:
Practice Address - Street 1:1125 SCHILLING BLVD E # 105TH
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-7078
Practice Address - Country:US
Practice Address - Phone:901-624-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPA00550363A00000X
TN4405363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant