Healthcare Provider Details

I. General information

NPI: 1780244608
Provider Name (Legal Business Name): JAMES D CADE HENDERSON CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 GOODYEAR AVE
GADSDEN AL
35903-1195
US

IV. Provider business mailing address

777 HAYNES RD
ALTOONA AL
35952-9798
US

V. Phone/Fax

Practice location:
  • Phone: 256-494-4000
  • Fax:
Mailing address:
  • Phone: 256-589-2360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number905765
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-156063
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1-156063
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: