MEDICARE: CARLIA RAE MASA

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
1	363A00000X	Physician Assistant	6753	TN

General Provider Information

NPI Number	:	1700625936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLIA RAE MASA

Provider Business Mailing Address
First Line	:	1900 PATTERSON ST STE 205
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2165
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 PATTERSON ST STE 205
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2165
Country	:	US
Telephone Number	:	615-642-4746
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	02/10/2026

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Directions to “ CARLIA RAE MASA ” Practice Location

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