Provider Demographics
NPI:1720734106
Name:GONZALEZ-HERNANDEZ, CASSANDRA ELENA (PA-C)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ELENA
Last Name:GONZALEZ-HERNANDEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2933 DEEPWOODS DR APT 7211
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-9534
Mailing Address - Country:US
Mailing Address - Phone:801-362-4739
Mailing Address - Fax:
Practice Address - Street 1:1234 HUFFMAN MILL RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8777
Practice Address - Country:US
Practice Address - Phone:336-506-1243
Practice Address - Fax:336-538-0530
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-12953363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant