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Individual

ASHLEA L CANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1755 HWY 34 E, STE 2200, NEWNAN, GA 30265-3190
(770) 502-2175
(770) 254-7843
Mailing address
1755 HWY 34 E, STE 2200, NEWNAN, GA 30265-3190
(770) 254-7843
(770) 683-6643

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
005659
GA
363A00000X
Physician Assistant
Primary
5569
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
146816327C
GA
Enumeration date
04/14/2010
Last updated
06/22/2023
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