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NPI Code Detail

MEDICARE: CAROLYN ROSE CLINE PA-C

MEDICARE: CAROLYN ROSE CLINE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant4458TN

General Provider Information

NPI Number : 1619566023
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN ROSE CLINE PA-C
Provider Business Mailing Address
First Line : 225 DELAY ST
Second Line :
City : ATHENS
State : TN
Zip : 37303-4720
Country : US
Telephone Number : 423-715-4985
Fax Number :
Provider Business Practice Location Address
First Line : 1060 WILLIAM WAY NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-4369
Country : US
Telephone Number : 423-478-1050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2021
Last Update Date : 12/15/2025

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Directions to “ CAROLYN ROSE CLINE PA-C” Practice Location

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