Individual
KATHLEEN A CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
179 N BROAD ST, NORWICH, NY 13815-1019
(607) 337-4111
Mailing address
310 COUNTY ROAD 2, GREENE, NY 13778-2291
(607) 656-4054
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
358194
NY
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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