Individual
DONNA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1755 COUNTY ROAD 81, BLUE MOUNTAIN, MS 38610-9657
(662) 538-4111
Mailing address
1755 COUNTY ROAD 81, BLUE MOUNTAIN, MS 38610-9657
(662) 538-4111
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R874646
MS
Other
Enumeration date
01/26/2015
Last updated
01/26/2015
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