Individual
MARY CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 PLEASANT ST # 206, DES MOINES, IA 50309-1406
(515) 241-5750
(515) 241-5757
Mailing address
1200 PLEASANT ST # 2016, DES MOINES, IA 50309-1406
(515) 241-5750
(515) 247-5757
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A154039
IA
Other
Enumeration date
03/14/2019
Last updated
06/04/2021
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