Individual
KRISTIN CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
7235 RIVERWALK WAY N, NOBLESVILLE, IN 46062-7001
(317) 214-4307
Mailing address
5488 PENNYCRESS DR, NOBLESVILLE, IN 46062-0009
(812) 661-0904
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31003191
MEDICARE B
IN
Enumeration date
03/09/2020
Last updated
03/09/2020
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