Individual
MRS. AMY CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
7125 MURRELL RD STE F, MELBOURNE, FL 32940-7999
(321) 361-5597
(321) 259-0547
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 361-5597
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN11021361
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
QP779
MEDICARE HF
FL
Enumeration date
09/26/2022
Last updated
05/15/2023
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