Individual
PEPPER NICOLE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1301 RIVERFRONT PKWY, CHATTANOOGA, TN 37402-2233
(423) 771-8186
Mailing address
8740 OOLTEWAH GEORGETOWN RD, OOLTEWAH, TN 37363-9707
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
83688
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83688
TN BOARD OF NURSING
TN
Enumeration date
04/28/2020
Last updated
04/28/2020
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