Individual
MS. LORI CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1300 N 12TH ST STE 612, PHOENIX, AZ 85006-2850
(602) 521-3000
Mailing address
5101 W ACOMA DR, GLENDALE, AZ 85306-4311
(602) 663-0869
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
236251
AZ
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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