Individual
MELISSA DAWN CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
308 ROSEDALE DR, ELIZABETHTOWN, KY 42701-1530
(270) 750-8574
Mailing address
308 ROSEDALE DR, ELIZABETHTOWN, KY 42701-1530
(270) 370-5668
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
1212515
KY
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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