Individual
DR. JESSICA DAUGHN DURST CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0102203494
VA
208000000X
Pediatrics Physician
Primary
E-9592
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212848003
—
AR
Enumeration date
09/23/2008
Last updated
12/09/2016
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