Individual
MRS. CARRIE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5 FEDERAL STREET, LAHEY DANVERS, DANVERS, MA 01923-3687
(978) 774-0730
(978) 775-0246
Mailing address
5 FEDERAL STREET, LAHEY DANVERS, DANVERS, MA 01923-3687
(978) 774-0730
(978) 775-0246
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN260601
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110079006A
—
MA
Enumeration date
06/05/2007
Last updated
01/09/2012
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