Individual
STEPHANIE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
64A JONES MILL RD, WOODBURY, GA 30293-2678
(706) 553-5367
Mailing address
1981 HENDRICKS CHURCH RD, THOMASTON, GA 30286-2047
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
RN249067
GA
363LG0600X
Gerontology Nurse Practitioner
RN249067
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN249067
GA
Other
Enumeration date
02/13/2022
Last updated
10/15/2025
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