Individual
LAURA J CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1950 CIRCLE OF HOPE, CLINIC 1A, SALT LAKE CITY, UT 84112-5550
(801) 585-0100
(801) 585-7902
Mailing address
127 SO. 500 EAST #600, SALT LAKE CITY, UT 84102-1971
(801) 587-6705
(801) 715-8228
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
269735-4405
UT
363LA2200X
Adult Health Nurse Practitioner
Primary
269735-4405
UT
363LC0200X
Critical Care Medicine Nurse Practitioner
269735-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D5804
—
UT
Enumeration date
05/23/2006
Last updated
11/11/2021
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