Individual
STEPHANIE MICHELLE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 6TH AVE S, BIRMINGHAM, AL 35233-1802
(205) 934-5612
(205) 975-9858
Mailing address
6254 SWANN RD, MOUNT OLIVE, AL 35117-3606
(205) 873-4457
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
1-077728
AL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
1-077728
AL
Other
Enumeration date
04/14/2021
Last updated
06/30/2023
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