Individual
SHANNON CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 YEARSLEY MILL RD, MEDIA, PA 19063-5593
(888) 227-3898
Mailing address
812R CRUM CREEK RD, SPRINGFIELD, PA 19064-1037
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN627631
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SPO30927
PA
Other
Enumeration date
09/18/2018
Last updated
01/22/2025
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