Individual
VERONICA LEA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1604 MLK BLVD, MALVERN, AR 72104
(501) 732-5400
(501) 325-9650
Mailing address
1604 MLK BLVD, MALVERN, AR 72104
(501) 732-5400
(501) 325-9650
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A004099
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204425758
—
AR
Enumeration date
07/02/2014
Last updated
02/29/2024
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