Individual
LYNNISE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
548632
NY
367500000X
Certified Registered Nurse Anesthetist
739399
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP115752
TX
Other
Enumeration date
10/17/2006
Last updated
06/08/2020
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