Individual
JENNIFER CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
380 9TH ST, FLORENCE, OR 97439-9470
(541) 997-7134
(541) 902-1320
Mailing address
260 HOSPITAL DR, SUITE 207, UKIAH, CA 95482-4568
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11485
CA
363L00000X
Nurse Practitioner
201801167NP-PP
OR
363L00000X
Nurse Practitioner
Primary
NUR-APRN-LIC-180218
MT
Other
Enumeration date
01/26/2017
Last updated
04/18/2025
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