Individual
MRS. REBECCA LYNN CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1810 MULKEY RD, SUITE 201, AUSTELL, GA 30106-1151
(770) 819-9262
(770) 819-0597
Mailing address
7913 HANNAH ROAD, WINSTON, GA 30187
(770) 947-1073
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN157546
GA
Other
Enumeration date
12/19/2006
Last updated
12/07/2011
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