Individual
MRS. JENNIFER CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
166 ALBANY TPKE STE 7, CANTON, CT 06019-2546
(860) 935-6680
Mailing address
166 ALBANY TPKE STE 7, CANTON, CT 06019-2546
(860) 935-6680
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5902
CT
363LF0000X
Family Nurse Practitioner
005902
CT
363LF0000X
Family Nurse Practitioner
Primary
5902
CT
Other
Enumeration date
10/02/2014
Last updated
04/18/2023
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