# MARIANNE T CANNON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972911824
- **Authorized official:** ANN MARIE MCGRANE (OFFICE MANAGER)
- **Authorized official phone:** (978) 535-6043

## Contact information

- **Practice address:** 100 CUMMINGS CTR STE 345F, BEVERLY, MA 01915-6501
- **Practice address phone:** (978) 535-6043
- **Practice address fax:** (978) 535-6047
- **Mailing address:** 100 CUMMINGS CTR STE 345F, BEVERLY, MA 01915-6501
- **Mailing address phone:** (978) 535-6043
- **Mailing address fax:** (978) 535-6047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0807X | Child & Adolescent Psychiatric/Mental Health Registered Nurse | RN101598 | MA | Yes |

## Other

- **Enumeration date:** 07/23/2014
- **Last updated:** 11/18/2016