Individual
MRS. MEGAN T. CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5875 BREMO RD, SUITE G-11, RICHMOND, VA 23226-1934
(804) 287-7804
(804) 287-7178
Mailing address
5875 BREMO RD, SUITE G-11, RICHMOND, VA 23226-1934
(804) 287-7804
(804) 287-7178
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024169121
VA
363LF0000X
Family Nurse Practitioner
24169121
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
09/25/2012
Last updated
02/12/2013
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