Individual
SAMUEL HARRISON CANNON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041353866
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100042105
—
WI
Enumeration date
03/27/2013
Last updated
04/10/2025
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