Individual
AMANDA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 E 2ND ST, KENLY, NC 27542-7794
(919) 284-4025
(919) 284-5965
Mailing address
PO BOX 275, KENLY, NC 27542-0275
(919) 284-4025
(919) 284-5965
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
5007198
NC
Other
Enumeration date
09/23/2014
Last updated
05/14/2015
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