Individual
CASSANDRA LYNN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20401 N 73RD ST, SCOTTSDALE, AZ 85255-4107
(480) 556-0446
Mailing address
2001 W ALVARADO RD, PHOENIX, AZ 85009-2830
(518) 847-6522
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
8178
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1176027
NCCPA
—
01
—
8178
ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS
AZ
Enumeration date
04/16/2019
Last updated
11/15/2020
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