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Individual

TAMMY GALLAGHER CANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
F.N.P.

Contact information

Practice address
1501 KINGS HWY, DEPARTMENT OF NEUROSURGERY, SHREVEPORT, LA 71103-4228
(318) 675-5161
Mailing address
PO BOX 33932, SHREVEPORT, LA 71130-3932
(318) 675-5161

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN100005-AP06307
LA
363LF0000X
Family Nurse Practitioner
AP06307
LA

Other

Enumeration date
12/09/2011
Last updated
03/30/2026
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