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General NPI Number Information
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NPI Number | 1619566023
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Entity Type | Individual
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Provider Name | CAROLYN ROSE CLINE PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1060 WILLIAM WAY NW
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City | CLEVELAND
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State | TN
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Zip | 37312-4369
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Country | US
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Telephone | 423-478-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 225 DELAY ST
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City | ATHENS
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State | TN
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Zip | 37303-4720
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Country | US
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Telephone | 423-715-4985
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4458
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License Number State | TN
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