Individual
SHANA COLE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
777 W. POPLAR AVE., SUITE 104, COLLIERVILLE, TN 38017
(901) 221-7175
(901) 221-7913
Mailing address
1992 HIGHWAY 51 S, COVINGTON, TN 38019-3623
(901) 476-1820
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000078550
TN
Other
Enumeration date
09/17/2013
Last updated
01/05/2024
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