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Individual

DR. JENIFER M CANNON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
9701 LANDMARK PARKWAY DR, SUITE 207, SAINT LOUIS, MO 63127-1665
(314) 842-4802
(314) 849-8721
Mailing address
12639 OLD TESSON RD, SUITE 115, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R8J94
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0700221
UNITED HEALTHCARE
MO
01
112746
BLUE CROSS BLUE SHIELD
MO
01
174439
HEALTHLINK
MO
01
4225543
AETNA
MO
Enumeration date
05/18/2006
Last updated
07/08/2007
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