Healthcare Provider Details

I. General information

NPI: 1538994637
Provider Name (Legal Business Name): ASHLYN CHERIE HENDERSON SPENCER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLYN CHERIE HENDERSON

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE ST STE G600
KANSAS CITY KS
66160-8501
US

IV. Provider business mailing address

4000 CAMBRIDGE ST STE G600
KANSAS CITY KS
66160-8501
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-9600
  • Fax:
Mailing address:
  • Phone: 913-588-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTC040
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: