Individual
CONSUELO NORWOOD CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
50 W WHITE ST, BRENTWOOD, NY 11717-1310
(631) 434-2439
Mailing address
50 W WHITE ST, BRENTWOOD, NY 11717-1310
(631) 434-2439
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
436036-1
NY
163WH0200X
Home Health Registered Nurse
436036-1
NY
Other
Enumeration date
08/26/2008
Last updated
01/05/2012
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