Individual
LORENA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
893 E 9400 S, SANDY, UT 84094-3671
(385) 335-7862
Mailing address
893 E 9400 S, SANDY, UT 84094-3671
(385) 335-7862
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11313685-4405
UT
363LF0000X
Family Nurse Practitioner
11313685-4405
UT
Other
Enumeration date
06/20/2019
Last updated
03/08/2021
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