Individual
AMANDA GRAVES CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
667 E 500 N STE 200, VINEYARD, UT 84059-6004
(801) 669-5758
(801) 216-8357
Mailing address
667 E 500 N STE 200, VINEYARD, UT 84059-6004
(801) 669-5758
(801) 216-8357
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9111041-4405
UT
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
911041
UT
Other
Enumeration date
07/12/2018
Last updated
11/15/2024
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