Individual
IZEGBEA M. CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 772-8189
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 772-8189
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3009546
KY
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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