Provider Demographics
NPI:1760557961
Name:CARDINAL, JOANNE H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:H
Last Name:CARDINAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:JOANNE
Other - Last Name:HEDGECOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2370 CORPORATE CIR STE 300
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7760
Mailing Address - Country:US
Mailing Address - Phone:702-910-3950
Mailing Address - Fax:
Practice Address - Street 1:1590 PASEO SAN LUIS STE 101
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4783
Practice Address - Country:US
Practice Address - Phone:520-220-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49449207Q00000X
WY3454A207Q00000X
NMMD2012-0689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ975698Medicaid
WY107146700Medicaid
WY2347OtherBLUE CROSS
A73038Medicare UPIN