Individual
LOIS E CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1665 UTICA AVE S, SAINT LOUIS PARK, MN 55416-3474
(952) 541-2500
Mailing address
8170 33RD AVE S, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
1025194
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
843325900
—
MN
Enumeration date
02/21/2006
Last updated
10/31/2022
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