Healthcare Provider Details

I. General information

NPI: 1114009396
Provider Name (Legal Business Name): HEATHER CASH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 S EASTERN AVE SUITE 309
HENDERSON NV
89052-3907
US

IV. Provider business mailing address

10001 S EASTERN AVE SUITE 309
HENDERSON NV
89052-3907
US

V. Phone/Fax

Practice location:
  • Phone: 702-269-6345
  • Fax: 702-269-9422
Mailing address:
  • Phone: 702-269-6345
  • Fax: 702-269-9422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA981
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: