Provider Demographics
NPI:1558091058
Name:MCLAREN, CAROLYNE (PA-C)
Entity type:Individual
Prefix:MS
First Name:CAROLYNE
Middle Name:
Last Name:MCLAREN
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 1:8355 WALNUT HILL LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4219
Mailing Address - Country:US
Mailing Address - Phone:214-466-6618
Mailing Address - Fax:
Practice Address - Street 1:8355 WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4219
Practice Address - Country:US
Practice Address - Phone:214-466-6618
Practice Address - Fax:469-586-5909
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023043565363A00000X
FLPA9116770363A00000X
NE3019363A00000X
IN10004606A363A00000X
NC010-15359363A00000X
LA345740363A00000X
MSPA00760363A00000X
IL085.009214363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant