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Individual

ASHLEY LYNNE CARDENAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1034 N 500 W, PROVO, UT 84604-3337
(801) 357-7850
Mailing address
1034 N 500 W, PROVO, UT 84604-3337

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11856778-1206
UT
363A00000X
Physician Assistant
PA195066
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1162379
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
01
11856778-1206
UTAH MEDICAL BOARD
UT
01
PA195066
OREGON MEDICAL BOARD
OR
Enumeration date
08/09/2019
Last updated
09/19/2024
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