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NPI 1609794072

NPI 1609794072 : LINA CAVENDER PHYSICIAN ASSISTANT : CARY, NC

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General NPI Number Information
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    NPI Number           |    1609794072
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    Entity Type          |    Individual 
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    Provider Name        |    LINA CAVENDER PHYSICIAN ASSISTANT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/06/2026
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    Last Update Date     |    07/06/2026
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Provider Practice Location Address
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    Address Line         |    210 TOWNE VILLAGE DR 
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    City                 |    CARY
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    State                |    NC
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    Zip                  |    27513-8910
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    Country              |    US
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    Telephone            |    919-859-3373
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    221 CROSS BLOSSOM RD 
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    City                 |    DURHAM
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    State                |    NC
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    Zip                  |    27703-7609
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    Country              |    US
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    Telephone            |    720-808-3626
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    NC
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