Individual
MARY KAY FADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
617 S 8TH ST, NASHVILLE, TN 37206-3819
(615) 228-8902
(615) 226-2679
Mailing address
601 W DUE WEST AVE, MADISON, TN 37115-4423
(615) 425-3333
(615) 425-3348
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000001679
TN
Other
Enumeration date
12/15/2005
Last updated
12/16/2010
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