Provider Demographics
NPI:1427718758
Name:HAYDEN, CARLA-MARIE SHERMETARO (PA)
Entity type:Individual
Prefix:
First Name:CARLA-MARIE
Middle Name:SHERMETARO
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2177 AUBURN RD STE A
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-3813
Mailing Address - Country:US
Mailing Address - Phone:586-737-7520
Mailing Address - Fax:586-737-7591
Practice Address - Street 1:2177 AUBURN RD STE A
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48317-3813
Practice Address - Country:US
Practice Address - Phone:586-737-7520
Practice Address - Fax:586-737-7591
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601010952363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical