NPI 1740511005 · live from the CMS NPI Registry
Clinton M Anderson, MT, PA-C
Physician Assistant, Medical in Henderson, NV. National Provider Identifier 1740511005, active.
NPI record
| NPI | 1740511005 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 2900 W Horizon Ridge Pkwy Ste 100, Henderson, NV 89052 |
| Practice phone | 702-357-8811 |
| Mailing address | Po Box 778413, Henderson, NV 89077 |
| Enumerated | January 26, 2010 |
| Last updated | March 17, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | 260790928 (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.