Provider Demographics
NPI:1588543888
Name:WALDEN, CARLY ANN (PA-C)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:ANN
Last Name:WALDEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 MIDDLETON DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27295-7671
Mailing Address - Country:US
Mailing Address - Phone:540-357-1278
Mailing Address - Fax:
Practice Address - Street 1:111 S SALISBURY GQ AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-8150
Practice Address - Country:US
Practice Address - Phone:704-279-1679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program