Individual
JENNIFER RENA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
330 HOSPITAL DR, BLDG C, STE 200, MACON, GA 31217-3899
(478) 745-1191
(478) 752-3869
Mailing address
330 HOSPITAL DR, BLDG C, STE 200, MACON, GA 31217-3899
(478) 745-1191
(478) 752-3869
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003040
GA
Other
Enumeration date
05/30/2006
Last updated
12/16/2009
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