Individual
JESSICA BRENNA MCCANNON
Active
Individual
JESSICA BRENNA MCCANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L-224519
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
234807
MA
207RP1001X
Pulmonary Disease Physician
234807
MA
Other
Enumeration date
02/26/2007
Last updated
03/29/2012
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