Individual
SPENCER CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
161 S DOOLEY CT, SALT LAKE CITY, UT 84102-4104
(801) 696-8513
Mailing address
161 S DOOLEY CT, SALT LAKE CITY, UT 84102-4104
(801) 696-8513
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8038048-3102
UT
163WP0200X
Pediatric Registered Nurse
8038048-3102
UT
363LP0200X
Pediatric Nurse Practitioner
Primary
8038048-4405
UT
Other
Enumeration date
10/11/2011
Last updated
03/04/2024
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