Individual
MRS. PENNI CAROL CANNADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
350 E PARKVIEW ST, DYERSBURG, TN 38024
(731) 334-5312
(731) 334-5311
Mailing address
350 E PARKVIEW ST, DYERSBURG, TN 38024-3110
(731) 334-5312
(731) 334-5311
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
13828
TN
363LA2200X
Adult Health Nurse Practitioner
0000013828
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q002946
—
TN
Enumeration date
12/15/2008
Last updated
09/28/2022
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