Provider Demographics
NPI:1962293191
Name:GROWDEN, CORY ANTHONY (CCMA, CPT)
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:ANTHONY
Last Name:GROWDEN
Suffix:
Gender:M
Credentials:CCMA, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2362 N GREEN VALLEY PKWY APT 214B
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-3672
Mailing Address - Country:US
Mailing Address - Phone:702-285-8186
Mailing Address - Fax:
Practice Address - Street 1:2362 N GREEN VALLEY PKWY APT 214B
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-3672
Practice Address - Country:US
Practice Address - Phone:702-285-8186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747A0650X, 3747P1801X, 2472E0500X, 251E00000X, 246RP1900X, 251F00000X, 261QI0500X
NV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG
No251E00000XAgenciesHome Health
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No251F00000XAgenciesHome Infusion
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy