Individual
MARSHA GAIL CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
215 CORPORATE DR, SUITE B, BEAVER DAM, WI 53916-3123
(920) 356-9415
(920) 356-9477
Mailing address
215 CORPORATE DR, SUITE B, BEAVER DAM, WI 53916-3123
(920) 356-9415
(920) 356-9477
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
71301-30
WI
Other
Enumeration date
07/23/2008
Last updated
07/23/2008
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