Individual
MS. MISTY CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15584 DUSTY TRL, NOBLESVILLE, IN 46060-7241
(317) 869-9259
Mailing address
15584 DUSTY TRL, NOBLESVILLE, IN 46060-7241
(317) 869-9259
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
1870144375
IN
Other
Enumeration date
02/06/2015
Last updated
02/06/2015
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