Individual
GINA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1517 DURHAM RD, PENNDEL, PA 19047-5707
(215) 752-1541
(215) 752-7195
Mailing address
1517 DURHAM RD, PENNDEL, PA 19047-5707
(215) 752-1541
(215) 752-7195
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN264410
PA
Other
Enumeration date
10/15/2015
Last updated
10/15/2015
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