Provider Demographics
NPI:1982368882
Name:CARDEN, JADE LAYELL (C-PNP)
Entity Type:Individual
Prefix:MRS
First Name:JADE
Middle Name:LAYELL
Last Name:CARDEN
Suffix:
Gender:F
Credentials:C-PNP
Other - Prefix:MISS
Other - First Name:JADE
Other - Middle Name:TIARRA
Other - Last Name:LAYELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14231 KEY DEER DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-6119
Mailing Address - Country:US
Mailing Address - Phone:804-221-1394
Mailing Address - Fax:
Practice Address - Street 1:5955 HARBOUR PARK DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2163
Practice Address - Country:US
Practice Address - Phone:804-744-4495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182830363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics