Individual
MRS. SHANNON JEANETTE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
5207 HICKORY PARK DR, SUITE C, GLEN ALLEN, VA 23059-2624
(804) 377-8981
(804) 377-8984
Mailing address
5207 HICKORY PARK DR, SUITE C, GLEN ALLEN, VA 23059-2624
(804) 377-8981
(804) 377-8984
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001191706
VA
363LP0200X
Pediatric Nurse Practitioner
Primary
0024167941
VA
Other
Enumeration date
02/15/2011
Last updated
12/08/2015
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