Individual
JEREMIAH CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1125 CHARLES AVE, WORLAND, WY 82401-4021
(307) 347-2449
(307) 864-5226
Mailing address
1503 COBURN AVE, WORLAND, WY 82401-3611
(303) 981-9215
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25938.1600
WY
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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