Individual
NYDIA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
223 CESSNA DR, SHREVEPORT, LA 71106-3421
(318) 350-7402
Mailing address
223 CESSNA DR, SHREVEPORT, LA 71106-3421
(318) 350-7402
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
215680
LA
Other
Enumeration date
07/01/2021
Last updated
07/01/2021
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