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Individual

JACQUELINE FELICIA CANNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN, AGPCNP

Contact information

Practice address
160 MINE LAKE CT STE 200, RALEIGH, NC 27615-6417
(855) 984-5121
Mailing address
160 MINE LAKE CT STE 200, RALEIGH, NC 27615-6417
(919) 630-3936

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
5021868
NC

Other

Enumeration date
03/14/2025
Last updated
03/24/2025
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