Provider Demographics
NPI:1497913594
Name:MCLAUGHLIN, CASSANDRA J (PA-C)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:J
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 N ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2616
Mailing Address - Country:US
Mailing Address - Phone:602-327-6609
Mailing Address - Fax:
Practice Address - Street 1:287 E. HUNT HIGHWAY
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-5096
Practice Address - Country:US
Practice Address - Phone:480-677-8282
Practice Address - Fax:480-535-0962
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ3828363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ417226Medicaid
AZ417226Medicaid
AZ1497913594Medicare PIN